Patient Account Representative
3 weeks ago
Job Summary:
The Insurance Patient Account Representative is an extension of a client's business office staff. This role is responsible for taking in-coming and making out-going calls to patients and insurance companies to resolve account balances. All client policies and procedures are followed.
Key Responsibilities:
- Account Review: Review patient accounts to identify and resolve discrepancies.
- Appeals & Denials: Process and respond to patient appeals and denials in a timely manner.
- Medicare/Medicaid: Ensure compliance with Medicare and Medicaid regulations and guidelines.
- Insurance Follow-up: Follow up with patients and insurance companies to resolve account balances.
- Customer Service: Provide excellent customer service to patients and insurance companies.
- Billing: Ensure accurate and timely billing of patient accounts.
- UB-04 & CMS 1500: Prepare and submit UB-04 and CMS 1500 claims for reimbursement.
- Complete all business-related requests and correspondence from patients and insurance companies.
- Responsible for working on 40-70 Accounts Per Day.
- Complete all assigned projects in a timely manner.
- Assist client and patients in all requested tasks.
- Communicate to Guidehouse management areas of concern or areas of improvement.
- Research and respond to all patient inquiries received by telephone and mail.
- Update patient demographic information and initiate account adjustments.
- Try to resolve account balances to zero prior to accounts being forwarded to an outside agency for collections.
Requirements:
- High School Diploma/GED or 3 years of relevant equivalent experience in lieu of High School Diploma/GED.
- 1+ year's medical provider experience working with UB04, appeals & denials.
Preferred Qualifications:
- Has active Medicare appeal process experience.
- 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 required.
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.
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