Patient Account Representative - Medicare, Medicaid, Commercial Claims

Guidehouse; San Antonio (TX); Hybrid; USD 32,000 - 52,000; Full time

Benefits offered by this job

Competitive benefits package

Hybrid work schedule

Paid holidays

Job summary

Guidehouse is seeking an Insurance Patient Account Representative in San Antonio, TX for a hybrid schedule (two days in-office, three days remote). You will manage patient and insurer communications, review accounts, and resolve balances across UB-04 and CMS 1500 claims.

Responsibilities include handling 40–70 accounts daily, researching inquiries, updating demographics, and assisting clients with tasks while following client policies and procedures.

Qualifications

• High School Diploma or GED (or 3 years relevant equivalent experience).
• 0-2+ years in office, business, operations, customer service or healthcare field.
• Proficient PC skills in Windows; Word and Excel essential.

Responsibilities

• Review accounts and resolve balances.
• Handle 40–70 accounts per day.
• Respond to patient and insurer inquiries via phone and mail.
• Work on UB-04 & CMS 1500 forms.
• Assist clients and patients with tasks and updates.
• Identify areas for process improvement and report to management.

Skills

Customer service

Office experience

Healthcare knowledge

Education

High School Diploma or GED

Tools

Word

Excel

Windows

Job description

Job Family:Patient Account RepresentativeTravel Required:NoneClearance Required:NoneThe 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 in the San Antonio, TX office and three days from home.Essential Job FunctionsAccount ReviewAppeals & DenialsMedicare/MedicaidInsurance Follow-upCustomer ServiceBillingUB-04 & CMS 1500Complete all business-related requests and correspondence from patients and insurance companies.Responsible for working on 40-70 Accounts Per DayComplete 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 portalsPC 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#IndeedSponsored#LI-DNIWhat 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 InsurancePersonal and Family Sick Time & Company Paid HolidaysPosition may be eligible for a discretionary variable incentive bonusParental Leave401(k) Retirement PlanBasic Life & Supplemental LifeHealth Savings Account, Dental/Vision & Dependent Care Flexible Spending AccountsShort-Term & Long-Term DisabilityTuition Reimbursement, Personal Development & Learning OpportunitiesSkills Development & CertificationsEmployee Referral ProgramCorporate Sponsored Events & Community OutreachEmergency Back-Up Childcare ProgramAbout GuidehouseGuidehouse 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 information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.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. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact [e-mail]. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.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.