Advanced Reimbursement Analyst - Healthcare Claims A/R

Guidehouse•Lewisville, TX

4d•$38,000 - $64,000•Hybrid

About The Position

The Advanced Reimbursement Analyst identifies, documents, and collects managed care and Medicare/Medicaid underpayments for Contract and Reimbursement Solutions clients. The role reviews payments against contractual terms, pursues additional payments from payors, and performs related duties as assigned. The position follows a hybrid schedule, with two days in either the Lewisville, Texas or El Segundo, California office and three days working from home.

Requirements

High school diploma/GED, or three years of relevant equivalent experience in lieu of a diploma/GED.
1–3+ years of experience in an office, business, operations, customer service, or healthcare field.

Nice To Haves

Experience working with Medicare/Medicaid claims and commercial payors.
Experience in healthcare billing/collections or claims processing in a hospital environment.
Experience with hospital systems such as Cerner, Epic, or Meditech.
Persuasive negotiation skills.

Responsibilities

Collect identified underpayments.
Document account activity that affects the account.
Reconcile accounts based on contract terms.
Work with the Contract department on pricing issues.
Review Medicare/Medicaid and managed care payments to verify consistency with the corresponding client-payor contract terms.
Keep current on Medicare/Medicaid payment changes.
Maintain accurate, timely, and thorough documentation regarding underpayments.
Bill payors for additional payment.
Perform timely and effective collection efforts.
Maintain departmental databases.
Produce periodic status reports.
Assist departmental staff with assigned tasks.
Maintain the confidentiality of company, client, and patient information, including private health information and contract terms.
Perform activities within the limitations of applicable laws and regulations.
Maximize collection of patient accounts.
Perform responsibilities professionally and consistently with client instructions.

Benefits

Medical, prescription, dental, and vision insurance.
Personal and family sick time and company-paid holidays.
May be eligible for a discretionary variable incentive bonus.
Parental leave.
401(k) retirement plan.
Basic life and supplemental life insurance.
Health Savings Account and dental/vision and dependent care Flexible Spending Accounts.
Short-term and long-term disability.
Tuition reimbursement, personal development, and learning opportunities.
Skills development and certifications.
Employee referral program.
Corporate-sponsored events and community outreach.
Emergency back-up childcare program.
Flexible benefits package.