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Central Denials Account Representative

2 months ago

Birmingham, Alabama, United States Guidehouse Full time
Job Summary

Guidehouse is seeking a highly skilled Central Denials Account Representative to join our team. As a key member of our organization, you will be responsible for conducting thorough account reviews to determine the appropriate action needed to resolve account balances.

Key Responsibilities
  • Conduct thorough account reviews to determine the appropriate action needed to resolve account balances.
  • Review and perform various tasks, including:
    • Electronic file reviews
    • Claim file reviews
    • Medical record reviews
    • Outbound calls to insurance companies to resolve claim denials and account balances
    • Performing non-clinical appeals
    • Assisting supervisors/managers with various projects
    • Escalating payer issues/trends to supervisors with relevant information
    • Communicating areas of concern or improvement to supervisors/managers
    • Resubmitting corrected claims and supporting documentation as needed
    • Communicating with other organizational departments to ensure proper handling of patient accounts
  • Perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure.
Requirements
  • High School Diploma or equivalent
  • 0-2 years of medical provider experience working with UB04, appeals, and denials
Preferred Qualifications
  • Basic computer skills
  • Good written and verbal communication skills
  • Ability to facilitate conversations with others and establish an understanding of the customer's issue/reason for contact
  • Ability to perform essential job functions with a high degree of independence, flexibility, and creative problem-solving techniques
  • Ability to interpret and apply reimbursement aspects of managed healthcare contracts
  • Attentive listening skills
  • Exceptional customer service skills, including effective and efficient problem-solving and analyzing skills
  • Ability to initiate and follow through on projects and work independently with minimal supervision required
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:

  • 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