Patient Account Representative - Physician Claims

Guidehouse•Lewisville, TX

1d•$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 required. The role works with other departments to support departmental goals and is responsible for resolving accounts, identifying solutions to problems, and informing management of payment patterns or other payer-specific issues. The position requires extensive knowledge of billing, accounts receivable follow-up, timely filing guidelines, and the ability to review remittance advices and electronic billing reports to determine the appropriate action. It emphasizes CMS-1500 claims and includes other related duties as assigned. Candidates living in the Lewisville, Texas, or Mitchell, South Dakota, regions follow a hybrid schedule: two days in the office and three days from home. Guidehouse offers a comprehensive total rewards package, including competitive compensation and benefits. The annual salary range is $34,000 to $56,000; compensation decisions depend on factors such as skills, experience, and training.

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

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 in the client’s system.
Work denials and take necessary actions to obtain account resolution.
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 billing and HIPAA processes follow applicable state and federal rules and regulations.
Complete assigned special projects within specified time frames.
Attend training sessions and seminars offered by the client and third-party payers.
Document each account worked in the client’s practice management system.
Make necessary corrections in the client’s practice management system.
Resolve or forward address or 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.
Perform required billing processes, follow-up, account resolution, adjustments, and scanning.
Identify solutions to problems and keep management informed of payer payment patterns and other issues.

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, 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.