PFS Senior Patient Account Representative

Job Family:

Patient Account Representative

Travel Required:

None

Clearance Required:

None

What You Will Do:

Senior Duties:

• Training fellow team members

• Variety of reports from leadership

• Assisting team members, providing/finding solutions and account guidance

• Assisting Supervisor/Manager as needed with various projects

Such duties may include, but are not limited to, the following responsibilities:

• Review and Resolve Blue Cross/Commercial Denials

• Submit Facility - nonclinical appeals

• Facilitate resolution by referring the matter to the issue/content expert.

• Escalate the matter to a supervisor, request the appropriate information or take appropriate action so that the issue expert can effectively resolve the matter.

• Resubmit Corrected Claims and supporting documentation as need for the patient experience.

• Communicate with other organizational departments to ensure proper handling of patient accounts.

• Communicates issues to management timely and performs other duties as assigned by direct supervisors.

• Perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure

What You Will Need:

• Required Qualifications: - HS Diploma or equivalent

• Excellent customer service skills

• Good written and verbal communications skills

• Basic computer skills

What Would Be Nice To Have:

• Qualifications Preferred Qualifications: - 1 - 3 years related or general knowledge of payor-specific or medical specialty billing

• Professional and calming tone of voice with complete command of the English language free of use of inappropriate grammar.

• Ability to facilitate conversations with others and establish an understanding of the customer's issue/reason for contact.

• Ability to perform essential job functions with high degree of independence, flexibility, and creative problem-solving techniques.

• Ability to maintain control of the call by de-escalating issues and instilling confidence that the resolution has been found. - Ability to function effectively under stress of conflicting demands on time and attention and, sometimes, under duress from difficult personalities.

• Ability to interpret and apply reimbursement aspects of managed healthcare contracts.

• Attentive listening skills.

• Ability to clearly articulate a response to the customer using appropriate voice modulation. - Bilingual (English/Spanish) preferred

• Exceptional customer service skills including effective and efficient problem solving and analyzing skills.

• Dialer experience preferredAdditional Requirements The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described.

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 Program

About Guidehouse
Guidehouse 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 crimin