Patient Account Representative - Physician Claims

Patient Account Representative

The Patient Account Representative 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 position is classified as a hybrid position working two days in the Lewisville, TX office and three days from home.

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
• Attends 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

What Would Be Nice To Have

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 :

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.