Senior Reimbursement Analyst: Medicare/Medicaid Underpayments

Guidehouse Inc.; Lewisville (TX); Hybrid; USD 38,000 - 64,000; Full time

Benefits offered by this job

Medical, Rx, Dental & Vision Insurance

401(k) Retirement Plan

Paid Holidays

Job summary

Guidehouse is seeking an Advanced Reimbursement Analyst to identify, document and collect underpayments from managed care, Medicare and Medicaid for clients under Reimbursement Solutions. The role supports hybrid work with two days in Lewisville, TX or El Segundo, CA and three days from home.

Responsibilities include collecting on underpayments, documenting activity, reconciling accounts per contract terms, and collaborating with the contracts team on pricing issues.

Qualifications

• High School Diploma / GED or 3 years of Relevant Equivalent Experience.
• 1-3+ years' experience in office, business, operations, customer service or healthcare field.

Responsibilities

• Collect on identified underpayments.
• Document activity that affects account.
• Reconcile accounts based on contract terms.
• Work with contract dept. on pricing issues.
• Review Medicare/Medicaid and managed care payments to verify consistency with payment terms of corresponding contract between client and payor.
• Keep current on Medicare/Medicaid payment changes.
• Maintain accurate, timely and thorough documentation regarding underpayments.
• Bill payors for additional payment.
• Perform timely and effective collection efforts.
• Maintain departmental databases.
• Produce periodic status reports.
• Assist departmental staff with assigned tasks.
• Maintain confidentiality of company, client and patient information.

Skills

Medicare/Medicaid claims experience

Healthcare billing

Persuasive negotiator

Education

High School Diploma / GED or 3 years of relevant equivalent experience

Tools

Cerner

Epic

Meditech

Job description

Guidehouse is seeking an Advanced Reimbursement Analyst to identify, document and collect underpayments from managed care, Medicare and Medicaid for clients under Reimbursement Solutions. The role supports hybrid work with two days in Lewisville, TX or El Segundo, CA and three days from home.

Responsibilities include collecting on underpayments, documenting activity, reconciling accounts per contract terms, and collaborating with the contracts team on pricing issues.