Patient Account Representative – Government HMO – Guidehouse – Birmingham, AL

Overview:

Guidehouse is a leading management consulting firm serving the public and commercial markets. We guide our clients forward towards new futures that build trust in society and your professional skills along the journey. Join us at Guidehouse.

Responsibilities:

The Patient Account Representative is an extension of a client’s business office staff. Representatives are responsible for making outgoing calls to insurance companies to resolve account balances. All client policies and procedures are followed. Representatives will perform any and all job related duties as assigned.

  • Summary for the position:
  • Account Review and Follow-up
  • Billing
  • Complete all business related requests and correspondence from patients and insurance companies
  • 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
  • Try to resolve account balances to zero prior to accounts being forwarded to an outside agency for collections


Responsibilities:

  • Maintain AR <30.90% for aging greater than 90 days.
  • Ensure the integrity of quality follow up and maintain a quality review score of 2.82 or higher monthly.
  • Maintain productivity standard of 100% (6.25 accounts per hour).
  • Begin working Metrix task list immediately upon clocking in.
  • Work between scheduled unit hours of 7:00 AM to 6:00 PM with the option of flex.
  • Implement the initial underpay process at the point of collection. It is the responsibility of each collector to calculate the expected reimbursement and identify any patient responsibility. With this information, the collector identifies and documents whether or not the claim has paid according to contract and verifies the balance on the account is correct. All information is to be documented clearly, concisely and completely in both Metrix and HealthQuest.
  • Continue follow-up efforts on all accounts worked, taking the appropriate action for the age and dollar amount of the account.
  • Streamline the denial process by ensuring clean claims and avoiding duplicate rebills.
  • Ensure all denials are adjusted using the correct code based on the root cause and for the dollar amount that we would have been paid.
  • It is the responsibility of each employee to communicate information, training opportunities, trends, issues, etc.
  • It is the responsibility of each employee to completely read and respond to all emails within a timely manner. General expectation is a response within the same day, even if the response is just an acknowledgment of receipt and that more research is needed.
  • It is the responsibility of each employee to listen and respond to all voicemails within a timely manner. General expectation is a response within the same day, even if that response is just an acknowledgment of receipt and that more research is needed.
  • It is the responsibility of each employee to complete all spreadsheets and reports timely and by the assigned deadline.

Qualifications:

  • High School Diploma or equivalent
  • 3 years medical office (medical billing/collecting) experience.
  • Familiar with Microsoft Word and Excel

Preferred:

  • Government HMO Billing/Follow up experience
  • CPAR certification
  • Excellent problem solving and critical thinking skills

Additional Requirements:

  • 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.

Disclaimer:


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.

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 or via email at [email protected] 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.


  • Medical, Rx, Dental & Vision Insurance
  • Personal and Family Sick Time & Company Paid Holidays
  • Parental Leave and Adoption Assistance
  • 401(k) Retirement Plan
  • Basic Life Voluntary Life Insurance
  • Health Savings Account, Healthcare, 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
  • Position may be eligible for a discretionary variable incentive bonus

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Source: Indeed.com
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