Patient Account Representative - Medicare, Medicaid, Commercial Claims

Guidehouse; El Segundo (CA); Hybrid; USD 34,000 - 56,000; Full time

Benefits offered by this job

Medical Insurance

401(k) Retirement Plan

Paid Holidays

Tuition Reimbursement

Employee Referral Program

Job summary

Guidehouse is seeking an Insurance Patient Account Representative to handle incoming/outgoing calls with patients and insurers to resolve balances, following client policies. This hybrid role requires two days in either Lewisville, TX or El Segundo, CA and three days from home.

You will review accounts, follow-ups, Medicare/Medicaid, and billing tasks, communicating clearly with teammates and customers. Strong Excel/Word skills and attention to detail are valued.

Qualifications

• High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.
• 0-2+ year’s experience in office, business, operations, customer service or healthcare field.

Responsibilities

• Account Review
• Appeals & Denials
• Medicare/Medicaid
• Insurance Follow-up
• Customer Service
• Billing
• UB-04 & CMS 1500
• Complete all business-related requests and correspondence from patients and insurance companies.
• Responsible for working on 40-70 Accounts Per Day
• Complete all assigned projects in a timely manner.
• Assist client and patients in all requested tasks.
• Communicate to Guidehouse management areas of concern or areas of improvement.
• Research and respond to all patient inquiries received by telephone and mail.
• Update patient demographic information and initiate account adjustments.
• Try to resolve account balances to zero prior to accounts being forwarded to an outside agency for collections.

Skills

Customer service

Office experience

Windows OS

Microsoft Word

Microsoft Excel

Education

High School Diploma / GED

Tools

Windows OS

Microsoft Word

Microsoft Excel

Job description

Job Family

Patient Account Representative

Travel Required

None

Clearance Required

None

What You Will Do

The Insurance Patient Account Representative is an extension of a client’s business office staff. Representatives are responsible for taking in-coming and making out-going calls to patients and insurance companies to resolve account balances. All client policies and procedures are followed. Representatives will perform any and all job-related duties as assigned.

This position will be on a hybrid schedule working two days either in the Lewisville, TX office or El Segundo, CA office and three days from home.

Essential Job Functions

• Account Review
• Appeals & Denials
• Medicare/Medicaid
• Insurance Follow-up
• Customer Service
• Billing
• UB-04 & CMS 1500
• Complete all business-related requests and correspondence from patients and insurance companies.
• Responsible for working on 40-70 Accounts Per Day
• Complete all assigned projects in a timely manner.
• Assist client and patients in all requested tasks.
• Communicate to Guidehouse management areas of concern or areas of improvement.
• Research and respond to all patient inquiries received by telephone and mail.
• Update patient demographic information and initiate account adjustments.
• Try to resolve account balances to zero prior to accounts being forwarded to an outside agency for collections.

What You Will Need

• High School Diploma / GED or 3 years of Relevant Equivalent Experience in Lieu of Diploma / GED.
• 0-2+ year’s experience in office, business, operations, customer service or healthcare field.

What Would Be Nice To Have

• Previous experience working in insurance portals
• PC skills in a Windows environment.
• Knowledge and utilization of desktop applications to include Word and Excel is essential.
• Ability to initiate and follow through on projects and work independently with minimal supervision

The annual salary range for this position is $34,000.00-$56,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

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.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [e-mail].

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or [e-mail]. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.

If you want to check the validity of correspondence you have received, please contact [e-mail].