Patient Account Representative - Medicare, Medicaid, Commercial Claims

Guidehouse•Lewisville, TX

9d•Hybrid

About The Position

The Insurance Patient Account Representative is an extension of a client’s business office staff. The representative handles incoming and outgoing calls with patients and insurance companies to resolve account balances while following all client policies and procedures. The position includes reviewing accounts, working appeals and denials, and following up on Medicare, Medicaid, and commercial insurance claims. Representatives work 40–70 accounts per day, respond to patient inquiries by telephone and mail, update demographic information, initiate account adjustments, and attempt to resolve balances before accounts are sent to an outside collections agency. This role follows a hybrid schedule: two days in either the Lewisville, Texas office or El Segundo, California office, and three days from home.

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

Review patient accounts and work appeals, denials, and Medicare, Medicaid, and commercial insurance follow-up.
Handle incoming and outgoing calls to patients and insurance companies to resolve account balances.
Complete business-related requests and correspondence from patients and insurance companies.
Work 40–70 accounts per day.
Complete assigned projects in a timely manner.
Assist clients and patients with requested tasks.
Communicate concerns and 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 forwarded to an outside collections agency.