Patient Account Representative - Physician Claims

Patient Account Representative - Physician Claims at Guidehouse summary :

The Patient Account Representative specializes in managing physician claims, performing billing processes, follow-ups, and account resolutions. This hybrid role requires communication with third-party payers to resolve account balances while adhering to regulatory guidelines. Additionally, this position involves monitoring denials and ensuring the integrity of patient and insurance information.

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 is a Hybrid position working two days in the Lewisville, TX office and three days working from home.

Questions regarding this position, you may contact Chris Rivera (Manager, Talent Acquisition) at 424-430-3111.

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 in 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

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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 Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, 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 RecruitingAccommodation@guidehouse.com . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

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.

Keywords :

patient accounts, billing processes, healthcare claims, account resolution, insurance verification, denials management, HIPAA compliance, payer communication, remittance advice, medical billing