Patient Account Representative – Medicare, Medicaid, Commercial Claims

🔥 22 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $34k - $56k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💰 Account Manager

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Guidehouse

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2018

🏥 Healthcare

🎖️ Defense

📦 Logistics

💰 Grant on 2023-02

Healthcare • Defense • Logistics

Guidehouse is a global consultancy offering advisory, digital, and managed services across commercial and public sectors. It is purpose-built to support industries such as national security, financial services, healthcare, energy, and infrastructure. Guidehouse collaborates with leaders to navigate complexity and drives transformational changes that impact the future. Their expertise spans data analytics, digital technologies, risk management, and more, with a strong emphasis on sustainability and innovation.

📋 Description

• Facilitate the billing and collection processes of outstanding accounts receivable • Communicate 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 • Monitor daily queues for customer services/quality and productivity to maintain acceptable level as established by the departments; alert management of high call volume patterns • Handle incoming and outgoing billing correspondence and phone inquiries relating to patient, third party administrators, attorneys, vendors and other insurance payers • Document conversations and/or actions taken to support all claims inquiries, review and/or reconsiderations; streamline the follow-up process of team members assisting on the file • Analyze claims to determine compliant and accurate coding, charging; review file to confirm demographic and billing information is updated • Work to resolve any claim or billing concerns and take appropriate action to escalate issues to management when appropriate • Perform follow-up processes on accounts to work towards a zero balance • File a timely reconsideration or review of claim with supporting documentation such as a corrected claim, medical records and letter of explanation as necessary; communicate with departments to gather information needed to resolve the claim • Perform balance transfers UB-04 & CMS 1500 • Complete all business-related requests and correspondence from patients and insurance companies • Responsible for working on average 35 Accounts Per Day • Complete all assigned projects in a timely manner • Assist client and patients in all requested tasks • Communicate to Guidehouse management areas of concern or areas of improvement • Research and respond to all patient inquiries received by telephone and mail • Update patient demographic information and initiate account adjustments • Try to resolve account balances to zero prior to accounts being forwarded to an outside agency for collections

🎯 Requirements

• High School Diploma / GED or 3 years of Relevant Equivalent Experience in Lieu of Diploma / GED • 0-2+ year's experience in office, business, operations, customer service or healthcare field • Previous experience working in insurance portals • PC skills in a Windows environment • Knowledge and utilization of desktop applications to include Word and Excel

🏖️ Benefits

• Medical, Rx, Dental & Vision Insurance • Personal and Family Sick Time & Company Paid Holidays • Position may be eligible for a discretionary variable incentive bonus • Parental Leave • 401(k) Retirement Plan • Basic Life & Supplemental Life • Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts • Short-Term & Long-Term Disability • Tuition Reimbursement, Personal Development & Learning Opportunities • Skills Development & Certifications • Employee Referral Program • Corporate Sponsored Events & Community Outreach • Emergency Back-Up Childcare Program