Central Denials Unit - Patient Account Representative

Guidehouse - Birmingham, AL

Full-time - Mid Level

Birmingham, AL

Professional, Scientific, and Technical Services

About the position

The Denials Patient Account Representative at Guidehouse is responsible for managing and preparing reports related to patient accounts, specifically focusing on denials. This role involves collaborating with subject matter experts to resolve issues, submitting appeals, and ensuring effective communication across departments to enhance the patient experience. The representative will also handle various tasks that may change frequently, requiring adaptability and efficiency.

Responsibilities

• Manage, update, and prepare reports for leadership regarding patient accounts.
• Assist supervisors and managers with various projects related to denials.
• Review and resolve denials, submitting facility and non-clinical appeals as necessary.
• Communicate with other organizational departments to ensure proper handling of patient accounts.
• Resubmit corrected claims and supporting documentation for patient experience.
• Escalate matters to supervisors and request necessary information for resolution.
• Perform a variety of duties that may change frequently without loss of efficiency.

Requirements

• High school diploma or GED.
• 1 - 3 years of related experience or general knowledge of payor-specific or medical specialty billing.

Nice-to-haves

• Professional client engagement experience.
• Ability to interpret and apply reimbursement aspects of managed healthcare contracts.
• Effective and efficient problem-solving and analyzing skills.

Benefits

• Health savings account
• Paid holidays
• Disability insurance
• Health insurance
• Dental insurance
• 401(k)
• Flexible spending account
• Tuition reimbursement
• Parental leave
• Vision insurance
• Life insurance
• Referral program