Central Denials Account Representative - Hospital, Onsite

Patient Account Representative

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

What You Will Need:

• HS Diploma or equivalent.
• 0-2 years medical billing experience working with UB04, appeals & denials.

What Would Be Nice to Have:

• Ability to interpret and apply reimbursement aspects of managed healthcare contracts.
• Exceptional customer service skills including effective and efficient problem solving and analyzing skills.

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.

• 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.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.