Patient Account Representative - Physician Claims

Guidehouse•Lewisville, TX

67d•$34,000 - $56,000•Hybrid

About The Position

The Patient Account Representative (PAR) performs billing processes, account follow-up and resolution, adjustments, and scanning as needed. The role works with other departments to help meet departmental facility goals and objectives, and is responsible for resolving accounts. It requires finding solutions to problems and keeping management informed about payment patterns and other issues involving specific payers. The position follows a hybrid schedule, with two days either in the Lewisville, Texas, or El Segundo, California, office and three days working from home. The representative uses knowledge of billing, accounts receivable follow-up, timely filing guidelines, remittance advices, and electronic payer billing reports to determine appropriate action. Other related duties may be assigned.

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 with 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

Contact third-party payers and guarantors through payer websites or by phone to resolve balances on assigned accounts.
Work correspondence within 24 hours of receipt and enter detailed notes about it into the client’s system.
Work denials and take necessary actions to resolve accounts.
Submit appeals, as appropriate, for non-clinical denials.
Monitor denials for trends and issues and report findings to the supervisor.
Bill or rebill claims as necessary.
Ensure the client follows state and federal billing rules and regulations, including HIPAA.
Complete assigned special projects within the specified time frames.
Attend training sessions and seminars offered by the client and third-party payers.
Document each worked account appropriately in the client practice management system.
Make necessary corrections in the client practice management system.
Resolve or forward address and plan changes as appropriate to maintain the integrity of the insurance master.
Update patient accounts with corrected demographic or insurance information.
Post adjustments according to standard operating procedures or leadership direction.
Handle internal and external customer calls professionally and courteously.