Advanced Reimbursement Analyst - Healthcare Claims A/R

Job Family :

Patient Account Representative

Travel Required :

None

Clearance Required :

None

What You Will Do :

The Advanced Reimbursement Analyst will identify, document and collect managed care, Medicare/Medicaid underpayments for Contract and Reimbursement Solutions Clients. Perform any and all related job duties as assigned.

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.

Essential Job Functions

• Collect on identified underpayments.

• Document any activity that affects account.

• Reconcile accounts based on contract terms.

• Work w/contract dept. on any pricing issues.

Duties and Responsibilities

• 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.

Client Responsibility:

• Maintain confidentiality of all private health information and contract terms.

• Perform all activities within the limitations of applicable laws and regulations.

• Maximize collection of patient accounts.

• Perform all responsibilities in a professional manner and consistent with the instructions provided by the client.

What You Will Need :

• High School Diploma / GED or 3 years of Relevant Equivalent Experience in Lieu of Diploma / GED.

• 1-3+ year's experience in office, business, operations, customer service or healthcare field.

What Would Be Nice To Have :

• Experience working with Medicare/Medicaid claims as well as Commercial Payors

• Experience in healthcare billing/collections or claims processing in a hospital environment

• Experience with hospital systems such as Cerner, Epic or Meditech preferred

• Persuasive negotiator.

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The annual salary range for this position is $38,000.00-$64,000.00. 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 View phone number on click.appcast.io or via email at View email address on click.appcast.io . 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 View email address on click.appcast.io . 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 View email address on click.appcast.io . 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.