Patient Account Representative - Medicare, Medicaid, Commercial Claims

Guidehouse•Lewisville, TX

11d•$34,000 - $56,000•Hybrid

About The Position

The Insurance Patient Account Representative extends a client’s business office staff, resolving patient and insurance account balances through incoming and outgoing calls. The representative follows all client policies and procedures and performs other job-related duties as assigned. The position follows a hybrid schedule: two days in either the Lewisville, Texas, or El Segundo, California, office and three days working from home. The representative reviews accounts, handles appeals and denials, follows up with Medicare, Medicaid, and commercial insurance, and supports billing and customer service functions. They work with UB-04 and CMS 1500 claims, process patient and insurer correspondence, and manage 40–70 accounts per day. The representative researches patient inquiries, updates demographic information, initiates account adjustments, and works to resolve balances before accounts are referred to an outside collections agency.

Requirements

High school diploma or GED, or three years of relevant equivalent experience in lieu of a diploma or GED.
0–2+ years of experience in an office, business, operations, customer service, or healthcare field.

Nice To Haves

Previous experience working in insurance portals.
PC skills in a Windows environment.
Knowledge and use of desktop applications, including Word and Excel.
Ability to initiate and follow through on projects and work independently with minimal supervision.

Responsibilities

Resolve patient and insurance account balances through incoming and outgoing calls.
Review accounts and manage appeals, denials, Medicare/Medicaid matters, insurance follow-up, customer service, and billing.
Work with UB-04 and CMS 1500 claims.
Complete business-related requests and correspondence from patients and insurance companies.
Work on 40–70 accounts per day.
Complete assigned projects in a timely manner.
Assist clients and patients with requested tasks.
Communicate areas of concern or opportunities for improvement to Guidehouse management.
Research and respond to patient inquiries received by telephone and mail.
Update patient demographic information and initiate account adjustments.
Attempt to resolve account balances before accounts are sent to an outside collections agency.
Follow client policies and procedures and perform other job-related duties as assigned.

Benefits

Medical, prescription, dental, and vision insurance.
Personal and family sick time and company-paid holidays.
Position 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.