Denials Account Representative – Hospital, Onsite

++Job Family++:
Patient Account Representative

++Travel Required++:
None

++Clearance Required++:
None ++What You Will Do++: The Central Denials Account Representative conducts thorough account reviews to determine the appropriate action needed to resolve the account balance. This includes reviewing and performing the following:

• 227 Electronic Files
• 835 Electronic Files
• UB04’s and 1500 Claim Files
• Medical Record
• Making outbound calls to Insurance Companies to resolve claim denials and account balances.
• Performing Non-Clinical Appeals.
• Assisting Supervisor/Manager as needed with various projects.
• Escalate payer issues/trends to a supervisor with the appropriate information or take appropriate action so that the issue expert can effectively resolve the matter.
• Communicate to Supervisor/Manager areas of concern or areas of improvement.
• Resubmit Corrected Claims and supporting documentation as need for the patient experience.
• Communicate with other organizational departments to ensure proper handling of patient accounts.
• Communicates issues to management timely and performs other duties as assigned by direct supervisors.
• Perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure.
• Ability to initiate and follow through on projects and work independently with minimal supervision required.
• Good written and verbal communications skills

++What You Will Need++:

• HS Diploma or equivalent.
• 0-2 years medical billing experience working with UB04, appeals & denials.

++What Would Be Nice to Have++:

• Ability to interpret and apply reimbursement aspects of managed healthcare contracts.
• Exceptional customer service skills including effective and efficient problem solving and analyzing skills.

++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

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.