CDU Patient Account Representative

Patient Account Representative

This position will submit requested information and documents to all payers via payer portals, fax, email or mail. This position will also review, and upload documents received by all payers to correct patient accounts. This position mitigates denials from payers by timely submitting all information needed to complete claims processing. The Central Denials Account Representative conducts thorough account reviews to determine the appropriate action needed to resolve the account balance. This includes reviewing and performing the following :

• 227 Electronic Files
• 835 Electronic Files
• UB04's and 1500 Claim Files
• Medical Record
• Making outbound calls to Insurance Companies to resolve claim denials and account balances.
• Performing Non-Clinical Appeals.
• Assisting Supervisor / Manager as needed with various projects.
• Escalate payer issues / trends to a supervisor with the appropriate information or take appropriate action so that the issue expert can effectively resolve the matter.
• Communicate to Supervisor / Manager areas of concern or areas of improvement.
• Resubmit Corrected Claims and supporting documentation as need for the patient experience.
• Communicate with other organizational departments to ensure proper handling of patient accounts.
• Communicates issues to management timely and performs other duties as assigned by direct supervisors.
• Perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure.
• Ability to initiate and follow through on projects and work independently with minimal supervision required.
• Good written and verbal communications skills

This position requires a HS Diploma or equivalent. 0-2 years medical billing experience working with UB04, appeals & denials is needed.

Ability to interpret and apply reimbursement aspects of managed healthcare contracts and exceptional customer service skills including effective and efficient problem solving and analyzing skills would be nice to have.

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 :

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 1-571-633-1711 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.