Guidehouse

PatientAccountRepresentative

Birmingham, Alabama, United States FULL TIME
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Mid+ candidates.

The Brief

“Patient Account Representative at Guidehouse. Skills: Medical Billing, Claims Processing. Interpret hospital policies, procedures, and services. Obtain solutions to problems and concerns”

Industry & Context.

Problems you'll solve

Evaluate complex; Identify root cause; Propose solutions

What They're Looking For.

Must Have

High school diploma or equivalent, 0-2 years of prior relevant experience, general knowledge of payer-specific or medical billing

Nice to Have

Previous experience in working credit balance accounts and processing patient and insurance overpayments, Experience working with specialized insurance companies, Ability to evaluate complex identify root cause and propose solutions, Experience working with UB04 and CMS 1500 claim forms, appeal and denials, Knowledge of CPT and ICD-10 coding

What You'll Do.

Interpret hospital policies

Obtain solutions to problems and concerns

Identify priority patient satisfaction issues

Suggest recommendations for resolution

Educate patients and families about patient rights

Handle patient inquiries

Correct/update billing details

Process overpayments made to UAHSF MSO /UAB Hospital

Process overpayment requests

Post contractual adjustments

Resolve credit balances

Resubmit claims and supporting documentation

Communicate with third party payers

Obtain insurance hierarchy information

Communicate issues to management

Full Job Description

**_Job Family_ :** Patient Account Representative ** _Travel Required_ :** None ** _Clearance Required_ :** None ** _What You Will Do_ :** Assists patients in interpreting hospital policies, procedures, and services, and in obtaining solutions to problems and concerns. Identifies priority patient satisfaction issues and suggests recommendations for resolution. Educates patients and their families about patient rights in accordance with state law. May also assist in the handling of patient inquiries, correct/update billing details. * Under general supervision and according to established policies and procedures, performs a variety of duties related to processing of overpayments made to UAHSF MSO /UAB Hospital**.** * Duties may include but are not limited to; timely and accurately processing of overpayment requests, post contractual adjustments, write offs, or transfers accordingly to resolve credit balances, resubmits claims and supporting documentation as needed, and communicates with third party payers in response to overpayment requests and/or to obtain insurance hierarchy information. * Communicates issues to management timely. Performs other duties as assigned by direct supervisor. **_What You Will Need_ :** **Patient Account Rep** * High school diploma or equivalent * 0-2 years of prior relevant experience and general knowledge of payer-specific or medical billing ** _What You Will Need_ :** **Patient Account Rep II** * High school diploma or equivalent * 1-3 years of prior relevant experience and general knowledge of payer-specific or medical billing ** _What Would Be Nice to Have_ :** * Previous experience in working credit balance accounts and processing patient and insurance overpayments**.** * Experience working with specialized insurance companies. * Ability to evaluate complex situations; identify root cause and propose solutions. * Experience working with UB04 and CMS 1500 claim forms, appeal and denials. * Knowledge of CPT and ICD-10 coding #IndeedSpon

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