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Healthcare Account Specialist

2 months ago

Lewisville, Texas, United States Guidehouse Full time

Job Family:
Healthcare Account Specialist

Travel Required:
None

Clearance Required:
None

Key Responsibilities:
The Healthcare Account Specialist - Focus on Physician Accounts serves as an integral part of the client’s financial operations team. Specialists are tasked with managing incoming and outgoing communications with patients and insurance providers to address account discrepancies. Adherence to all client protocols and procedures is mandatory. Specialists will undertake any job-related responsibilities as assigned. This role features a flexible hybrid work schedule, allowing for two days in the office and three days remotely.

For inquiries regarding this position, please reach out to the designated contact within the organization.

Essential Duties:
  • Handle physician and hospital claims efficiently.
  • Conduct thorough account reviews and manage appeals and denials.
  • Engage in follow-ups with Medicare/Medicaid and other insurance entities.
  • Provide exceptional customer service and support for billing inquiries.
  • Process UB-04 and CMS 1500 forms accurately.

Responsibilities Include:
Addressing all business-related requests and communications from patients and insurance companies.
Managing a workload of 40-70 accounts daily.
Completing all assigned tasks promptly and assisting clients and patients with their needs.
Reporting any concerns or areas for improvement to management.
Researching and responding to patient inquiries received via phone and mail.
Updating patient demographic data and initiating necessary account adjustments.
Striving to resolve account balances to zero before escalating to external collection agencies.


Qualifications:
High School Diploma/GED or 3 years of relevant experience in lieu of diploma/GED. 1-3 years of pertinent experience preferred.
Preferred Skills:
  • 1+ year of experience in a medical provider setting, particularly with UB04, appeals, and denials.
  • Familiarity with hospital or EOB claims.
  • Proficient PC skills in a Windows environment, including knowledge of Word and Excel.
  • Ability to initiate and manage projects independently with minimal supervision.

What We Offer:
Guidehouse provides a comprehensive rewards package that includes competitive compensation and a flexible benefits plan, reflecting our commitment to fostering a diverse and inclusive workplace.
Benefits Include:
  • Medical, Rx, Dental & Vision Insurance
  • Personal and Family Sick Time & Company Paid Holidays
  • Potential eligibility for a discretionary variable incentive bonus
  • Parental Leave
  • 401(k) Retirement Plan
  • Basic Life & Supplemental Life Insurance
  • 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.