Patient Account Representative - Physician Claims

Job Family : Patient Account Representative
Travel Required : None
Clearance Required : None
What You Will Do :
The Patient Account Representative (PAR) - Physician Claims 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 in office and three days from home. Company office locations pertaining to this opening include El Segundo, CA, Lewisville, TX and San Antonio, TX.
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
* Emphasis working Physician Claims CMS-1500's
* 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.
* 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
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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 or via email at (mailto: ) . 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 (mailto: ) . 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 (mailto: ) . 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.