Patient Account Representative - Diagnostic Scheduling Authorizations
Guidehouse
Job Family :
Patient Account Representative
Travel Required :
Clearance Required :
This role is 100% onsite in San Antonio TX. Candidates must live within 50 miles of the office.
What You Will Do :
The Patient Account Representative obtains payer authorizations for scheduled diagnostic services. The role verifies authorization requirements submits complete requests follows pending cases through determination and communicates issues that could delay service or create authorization-related denials.
Diagnostic scheduling authorization is the current and primary assignment. Based on future business or client needs the role may transition to post-bill insurance A/R follow-up or another revenue cycle function; no transition date or future assignment has been established.
What You Will Need :
- High School Diploma or GED or 3 years of relevant experience in lieu of the education
- 1-3 years of experience in healthcare revenue cycle patient access insurance verification prior authorization diagnostic scheduling or a related healthcare operation.
- Experience obtaining authorizations for imaging diagnostic outpatient or procedural services.
- Working knowledge of insurance eligibility benefits and authorization processes for government and commercial payers including Medicaid Medicare Advantage Veterans Affairs (VA) workers compensation managed care organizations (HMO/PPO) and commercial carriers.
- Strong written and verbal communication skills with the ability to accurately document payer interactions account activity follow-up efforts and resolution outcomes.
- Strong attention to detail organization time management and accountability.
- Ability to interpret payer guidelines and use payer portals authorization tools electronic health records and work queues.
- Ability to work independently while meeting established productivity quality accuracy and turnaround-time expectations.
What Would Be Nice To Have :
- Experience using Epic Meditech or another electronic health record payer portals and scheduling or authorization workqueues.
- Knowledge of medical necessity requirements and authorization-related denial prevention.
- Experience with insurance A/R follow-up or other revenue cycle functions is helpful for potential future reassignment but is not required for the current role.
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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 EmployerProtected 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- or via email at . 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 @ or . 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 Guidehouses Ethics Hotline. If you want to check the validity of correspondence you have received please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicants 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.
Required Experience:
Unclear Seniority
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