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Patient Account Representative - Medi-Cal / HMO Claims Follow-up

Company: Guidehouse
Location: Gardena
Posted on: July 5, 2024

Job Description:

Job Family:Patient Account RepresentativeTravel Required:NoneClearance Required:NoneWhat You Will Do: -The Insurance Patient Account Representative - Medi-Cal / HMO Emphasis 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. -This position will be on a hybrid schedule working two days in the office and three days from home.Questions regarding this position, you may contact Chris Rivera (Manager, Talent Acquisition) at (424) 430-3111Essential Job Functions

  • Medi-Cal & HMO Claims
  • Account Review
  • Appeals & Denials
  • Medicare/Medicaid
  • Insurance Follow-up
  • Customer Service
  • Billing
  • UB-04 & CMS 1500
    • Complete all business-related requests and correspondence from patients and insurance companies.
    • Responsible for working on 40-70 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.What You Will Need:
      • High School Diploma
      • 1+ year's medical provider experience working with UB04, appeals & denials.What Would Be Nice To Have:
        • Medi-Cal & HMO claims emphasis
        • PC skills in a Windows environment are required. Knowledge and utilization of desktop applications to include Word and Excel is essential.
        • Ability to initiate and follow through on projects and work independently with minimal supervision required.#IndeedSponsoredThe annual salary range for this position is $37,600.00-$56,400.00. 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.What We Offer: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.Benefits include:
          • 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 ProgramAbout GuidehouseGuidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.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.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 . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.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.

Keywords: Guidehouse, Gardena , Patient Account Representative - Medi-Cal / HMO Claims Follow-up, Other , Gardena, California

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