Patient Account Representative - Physician Claims

Guidehouse Inc.; Lewisville (TX); Hybrid; USD 34,000 - 56,000; Full time

Benefits offered by this job

Medical, Rx, Dental & Vision Insurance

Personal and Family Sick Time &Company

Company Paid Holidays

Discretionary variable incentive bonus

401(k) Retirement Plan

Life insurance

Health Savings Account, D/V & DCFSA

Disability (Short/Long Term)

Tuition Reimbursement

Learning opportunities

Certifications

Employee referral program

Community outreach

Emergency back-up childcare

Job summary

Guidehouse Inc. is seeking a Patient Account Representative to manage billing processes, follow-up, account resolution, and scanning as required. The role collaborates with multiple departments to meet facility goals and ensures timely remittance analyses and corrections.

The position supports a hybrid work model (two in-office days in Lewisville, TX or El Segundo, CA and three days remote) with strong emphasis on payer communications and denials management.

Qualifications

• High School Diploma / GED or 3 years of relevant equivalent experience.
• 0-2+ years' experience in office, business, operations, customer service or healthcare field.
• Ability to initiate and follow through on projects and work independently with minimal supervision.

Responsibilities

• Contacts third party payers and guarantors via payer websites or by phone to resolve account balances on all assigned accounts.
• Work all correspondence within 24 hours of receipt; detail notes enter in client system.
• Work all denials taking necessary actions to obtain account resolution.
• Submits appeals for non-clinical denials as appropriate.
• Monitors denials for trends and reports findings to supervisor.
• Bills or re-bills claims as necessary.
• Resolves or forwards changes to ensure integrity of insurance master.

Skills

Billing knowledge

Attention to detail

Communication skills

Microsoft Excel

Education

High School Diploma / GED

Tools

Payer portals

Windows

Word

Excel

Job description

Job Family :
Patient Account Representative

Travel Required :
None

Clearance Required :
None

What You Will Do :

The Patient Account Representative (PAR) is expected to perform specific billing processes, follow-up, account resolution, adjustments and scanning as required. This position works with other departments to facilitate the meeting of both departmental facility goals and objectives. This position is responsible for account resolution. Ability to find solutions to problems and keeping management informed of patterns regarding payments and or other issues with specific payers is essential

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.

The Patient Account Representative has an extensive knowledge of billing, accounts receivable follow-up, timely filing guidelines and the ability to effectively review remittance advices and electronic billing reports from payer to determine the action required. This position performs all related job duties as assigned.

Duties and Responsibilities

• Contacts third party payers and guarantors via payer websites or by phone to resolve account balances on all assigned accounts.
• Work all correspondence within 24 hours or receipt. Detail notes regarding correspondence must be entered into the client's system
• Works all denials taking necessary actions to obtain account resolution
• Submits appeals, as appropriate, for all non-clinical denials
• Monitors all denials for trends and issues and reports findings to supervisor
• Bills or re-bills claims as necessary
• Ensures the client follows all state and federal rules and regulations both billing and HIPAA
• Completes assigned special projects within the time frames given
• Attend training sessions and seminars offered by the Client and Third-Party Payers.
• Appropriately documents each account worked in client practice management system
• Makes necessary corrections in client practice management system.
• Resolves or forwards all address and / or plan changes as appropriate to ensure the integrity of the insurance master is maintained
• Updates patient accounts with corrected demographic or insurance information
• Posts adjustments based on standard operating procedures or as directed by leadership
• Handles all customer calls both internal and external in a professional and courteous manner.

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 with insurance portals
• PC skills in a Windows environment are required.
• 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 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 @g