Patient Account Representative - Denials

Guidehouse•Birmingham, AL

About The Position

The Patient Account Representative (PAR) assists with reviewing denied insurance claims and following up on accounts in a healthcare revenue cycle environment. The role reviews denied or unpaid insurance claims, identifies reasons for denials, and follows up with insurers in a timely manner to support accurate claim processing and payment. The PAR works with the team, leadership, and the client to identify opportunities for improvement within the Revenue Cycle.

Requirements

High school diploma or GED, or 2+ years of relevant work experience in lieu of education.
0–2+ years of work experience in healthcare, health insurance, finance, or customer service.
Working knowledge of health insurance.

Nice To Haves

Experience with multiple payers in a high-volume environment.
Basic knowledge of medical billing, insurance claims, and revenue cycle.
Understanding of insurance guidelines.
Ability to interpret remits/EOBs (explanation of benefits).
Basic knowledge of CPT, ICD-10, and HCPCS.
Knowledge of HIPAA regulations and patient privacy requirements.
Strong attention to detail and organizational skills.
Effective verbal and written communication skills.
Proficiency with Microsoft Office, specifically Excel and Word.
Ability to prioritize tasks.
Strong analytical and problem-solving skills.

Responsibilities

Review denied or unpaid insurance claims.
Identify reasons for claim denials.
Follow up with patients' insurance companies in a timely manner to support accurate claim processing and payment.
Work with the team, leadership, and the client to identify opportunities for improvement within the Revenue Cycle.

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.