Patient Account Representative - Medicare, Medicaid, Commercial Claims

<p style="text-align:left"><b><u>Job Family</u>:</b></p>Patient Account Representative<p style="text-align:left"><br><b><u>Travel Required</u>:</b></p>None<p style="text-align:left"><br><b><u>Clearance Required</u>:</b></p>None<p style="text-align:inherit"></p><p style="text-align:inherit"></p><p><b><u>What You Will Do</u>:</b><br> </p><p>The<b> Insurance Patient Account Representative</b> is an extension of a client’s business office staff. Representatives are responsible for taking in-coming and making out-going calls to patients and insurance companies to resolve account balances. All client policies and procedures are followed. Representatives will perform any and all job-related duties as assigned.</p><p></p><p><b><u>Essential Job Functions</u></b></p><ul><li><p>Facilitates the billing and collection processes of outstanding accounts receivable</p></li><li><p>Communicates with internal and external contacts to explain primary, secondary and tertiary billing, collection and resolution of claims including Medicare and other government and nongovernment accounts</p></li><li><p>Monitors daily queues for customer services/quality and productivity to maintain acceptable level as established by the departments; alerts management of high call volume patterns</p></li><li><p>Handles incoming and outgoing billing correspondence and phone inquiries relating to patient, third party administrators, attorneys, vendors and other insurance payers</p></li><li><p>Documents conversations and/or actions taken to support all claims inquiries, review and/or reconsiderations; streamlines the follow-up process of team members assisting on the file</p></li><li><p>Analyzes claims to determine compliant and accurate coding, charging; reviews file to confirm demographic and billing information is updated</p></li><li><p>Works to resolve any claim or billing concerns and takes appropriate action to escalate issues to management when appropriate</p></li><li><p>Performs follow-up processes on accounts to work towards a zero balance</p></li><li><p>Files a timely reconsideration or review of claim with supporting documentation such as a corrected claim, medical records and letter of explanation as necessary; communicates with departments to gather information needed to resolve the claim</p></li><li><p>Performs balance transfers</p></li><li><p>UB-04 & CMS 1500</p></li><li><p>Complete all business-related requests and correspondence from patients and insurance companies.</p></li><li><p>Responsible for working on average 35 Accounts Per Day</p></li><li><p>Complete all assigned projects in a timely manner. </p></li><li><p>Assist client and patients in all requested tasks.</p></li><li><p>Communicate to Guidehouse management areas of concern or areas of improvement. </p></li><li><p>Research and respond to all patient inquiries received by telephone and mail.</p></li><li><p>Update patient demographic information and initiate account adjustments.</p></li><li><p>Try to resolve account balances to zero prior to accounts being forwarded to an outside agency for collections.</p></li></ul><p><br><b><u>What You Will Need</u>:</b></p><ul><li><p>High School Diploma / GED or 3 years of Relevant Equivalent Experience in Lieu of Diploma / GED.</p></li><li><p>6 months - 2+ year's experience in office, business, operations, customer service or healthcare field.</p></li></ul><p></p><p><b><u>What Would Be Nice To Have</u>:</b></p><ul><li><p>Previous experience working in insurance portals</p></li><li><p>PC skills in a Windows environment.</p></li><li><p>Knowledge and utilization of desktop applications to include Word and Excel is essential.</p></li><li><p>Ability to initiate and follow through on projects and work independently with minimal supervision</p></li></ul><p></p><p>#IndeedSponsored</p><p></p><p>#LI-DNI</p><p style="text-align:inherit"></p><p style="text-align:inherit"></p>The annual salary range for this position is <span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">$34,000.00-$56,000.00.</span> Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.<p><br><b><u>What We Offer</u>:</b></p><p>Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.</p><p></p><p>Benefits include:</p><ul><li><p>Medical, Rx, Dental & Vision Insurance</p></li><li><p>Personal and Family Sick Time & Company Paid Holidays</p></li><li><p>Position may be eligible for a discretionary variable incentive bonus</p></li><li><p>Parental Leave</p></li><li><p>401(k) Retirement Plan</p></li><li><p>Basic Life & Supplemental Life</p></li><li><p>Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts</p></li><li><p>Short-Term & Long-Term Disability</p></li><li><p>Tuition Reimbursement, Personal Development & Learning Opportunities</p></li><li><p>Skills Development & Certifications</p></li><li><p>Employee Referral Program</p></li><li><p>Corporate Sponsored Events & Community Outreach</p></li><li><p>Emergency Back-Up Childcare Program</p></li></ul><p></p><p><u><b>About Guidehouse</b></u></p><p>Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.</p><p></p><p>Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.</p><p></p><p>If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at <a href="mailto:RecruitingAccommodation@guidehouse.com" target="_blank" rel="noopener noreferrer"><span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">RecruitingAccommodation@guidehouse.com</span></a>. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.</p><p></p><p>All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or <a href="mailto:guidehouse@myworkday.com" target="_blank" rel="noopener noreferrer"><span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">guidehouse@myworkday.com</span></a>.  Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.  Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.</p><p></p><p>If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact <a href="mailto:recruiting@guidehouse.com" target="_blank" rel="noopener noreferrer"><span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">recruiting@guidehouse.com</span></a>. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.</p><p></p><p><i>Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.</i></p>

Back to blog

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...