Patient Account Representative- Central Denials

Guidehouse; Birmingham (AL); On-site; USD 38,000 - 48,000; Full time

Benefits offered by this job

Medical, Rx, Dental & Vision Insurance

401(k) Retirement Plan

Tuition Reimbursement

Job summary

Guidehouse is seeking a Patient Account Representative to support billing and denials resolution. The role involves submitting information to payers, reviewing accounts, and coordinating with various departments to ensure accurate patient balances.

Candidates typically have HS diploma and up to 2 years of medical billing experience, with strong communication and customer service skills. The position offers comprehensive benefits and a focus on teamwork.

Qualifications

• HS diploma or equivalent required.
• 0–2 years medical billing experience with UB04, appeals and denials.
• Ability to interpret reimbursement aspects of managed healthcare contracts is a plus.

Responsibilities

• Submit requested information and documents to payers via portals, fax, email or mail.
• Review and upload documents to correct patient accounts.
• Mitigate denials by timely submitting all information needed for claims processing.
• Conduct thorough account reviews to determine actions needed to resolve balances.
• Make outbound calls to insurance companies to resolve denials and balances.
• Escalate payer issues to supervisor and communicate areas of concern.
• Resubmit corrected claims and supporting documentation for the patient experience.
• Coordinate with other departments to ensure proper handling of patient accounts.
• Initiate and follow through on projects and work independently with minimal supervision.
• Maintain good written and verbal communications.

Skills

Medical billing

Communication skills

Customer service

Education

HS Diploma or equivalent

Tools

UB04 forms

Payer portals

Job description

++Job Family++:
Patient Account Representative

++Travel Required++:
None

++Clearance Required++:
None

++What You Will Do++:

This position will submit requested information and documents to all payers via payer portals, fax, email or mail. This position will also review, and upload documents received by all payers to correct patient accounts. This position mitigates denials from payers by timely submitting all information needed to complete claims processing.

The Central Denials Account Representative conducts thorough account reviews to determine the appropriate action needed to resolve the account balance. This includes reviewing and performing the following:

• 227 Electronic Files
• 835 Electronic Files
• UB04’s and 1500 Claim Files
• Medical Record
• Making outbound calls to Insurance Companies to resolve claim denials and account balances.
• Performing Non-Clinical Appeals.
• Assisting Supervisor/Manager as needed with various projects.
• Escalate payer issues/trends to a supervisor with the appropriate information or take appropriate action so that the issue expert can effectively resolve the matter.
• Communicate to Supervisor/Manager areas of concern or areas of improvement.
• Resubmit Corrected Claims and supporting documentation as need for the patient experience.
• Communicate with other organizational departments to ensure proper handling of patient accounts.
• Communicates issues to management timely and performs other duties as assigned by direct supervisors.
• Perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure.
• Ability to initiate and follow through on projects and work independently with minimal supervision required.
• Good written and verbal communications skills

++What You Will Need++:

• HS Diploma or equivalent.
• 0-2 years medical billing experience working with UB04, appeals & denials.

++What Would Be Nice to Have++:

• Ability to interpret and apply reimbursement aspects of managed healthcare contracts.
• Exceptional customer service skills including effective and efficient problem solving and analyzing skills.

LI-DNI

.

++What We Offer++:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

++About Guidehouse++

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.