The Medicare, Medicaid or Tricare Patient Account Representative is an extension of a hospital/physician’s business office staff. Representatives are responsible for working Medicare related accounts by accessing DDE/FISS and by identifying the next step required to resolve/collect on the account balance. Representatives are also responsible for taking in-coming and making out-going calls to insurance companies and patients when necessary to resolve and collect debt on account balances. All client policies and procedures are followed. Representatives will perform any and all job-related duties as assigned.
Questions regarding this position, feel free to contact Chris Rivera (Manager, Talent Acquisition) at (714) 361-6836.
Essential Job Functions
- Medicare, Medicaid, Tricare Insurance Follow-Up
- Account Review
- Eligibility Checks
- Appeals & Denial Resolution
- Return to Provider / T-Screen
- Customer Service
Duties and Responsibilities
- Responsible for working 40-70 Accounts Per Day and maintaining above 90% quality audit score.
- Knowledge of Medicare filing guidelines.
- Complying with CMS regulations.
- Identify payer specific trends and issues.
- Completing all assigned projects in a timely manner.
- Assist client and patients in all requested tasks.
- Communicate to Navigant/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.
Education /Qualifications /Experience
- High School Diploma, GED or equivalent
- 1+ years’ experience working with Medicare.
- Hospital or Physician CBO experience is a plus, but not required.
- 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.
· The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described.
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.
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.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
Rewards and Benefits
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.
Job Type: Full-time
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Employee discount
- Flexible schedule
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Parental leave
- Referral program
- Retirement plan
- Vision insurance
- 8 hour shift
- Day shift
- Monday to Friday
- Waiting period may apply
- Temporarily due to COVID-19
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