Patient Access Representative – Notification of Admission

Job Family:

Patient Account Representative

Travel Required:

None

Clearance Required:

None

Guidehouse is a leading provider of consulting and managed services to healthcare organizations nationwide. Our teams help providers improve financial performance, operational efficiency, and patient outcomes through innovative revenue cycle solutions.

 

What You Will Do:

The Patient Access Representative – Notification of Admission Specialist supports Guidehouse’s healthcare revenue cycle operations by completing accurate, timely payer notifications for inpatient and observation admissions. This role helps protect reimbursement, reduce avoidable authorization and notification-related denials, and support consistent performance across client revenue cycle operations.

 

This individual will collaborate with Patient Access, Case Management, Utilization Review, Health Information Management, Payer Representatives, and Guidehouse operational leadership to ensure admissions are appropriately identified, submitted, documented, and escalated through resolution.

 

This position works in a 100% remote environment.

 

Job Responsibilities Include:

 

·       Reviewing daily inpatient and observation admission reports to identify accounts requiring payer notification.

·       Submitting “Notification of Admission” requests to commercial, Medicare Advantage, Medicaid Managed Care, and other third-party payers in accordance with payer, regulatory, contractual, and client-specific requirements.

·       Verifying coverage, eligibility, and account information prior to submission to support clean, accurate notifications.

·       Documenting confirmation numbers, reference numbers, payer responses, and related communications in designated client and Guidehouse systems.

·       Monitoring pending notifications, follow up on outstanding requests, and resolve issues within required timelines.

·       Escalating accounts at risk for missed notification deadlines, authorization-related denials, or reimbursement impact.

·       Collaborating with Utilization Review, Case Management, and other operational teams to obtain supporting clinical or account information as needed.

·       Maintaining current working knowledge of payer-specific notification requirements, client workflows, and standard operating procedures.

·       Identifying trends contributing to notification delays, defects, or denials and communicate improvement opportunities to leadership.

·       Supporting quality assurance reviews, reporting activities, training reinforcement, and continuous performance improvement initiatives.

·       Meeting or exceeding productivity, quality, timeliness, and service level expectations established by Guidehouse and client organizations.

 

What You Will Need:

 

·       High School Diploma or GED OR 3 years of Relevant Equivalent Experience in Lieu of Education

·       1+ years of experience in healthcare revenue cycle, patient access, insurance verification, authorization, utilization review support, or related healthcare operations

·       Working knowledge of commercial, Medicare, Medicaid, and managed care payer requirements.

·       Working knowledge of hospital inpatient and observation workflows.

·       Professional experience documenting payer interactions and account activities clear and concisely

·       Proficiency with Microsoft Office applications, including Excel and Outlook.

 

What Would Be Nice To Have:

·       Experien