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Guidehouse

Guidehouse, a "next-generation consultancy" and a portfolio company of Veritas Capital, provides management, risk consulting, and technology services to help cl

Patient Access Representative – Notification of Admission

Location

United States

Posted

11 days ago

Salary

$35K - $58K / year

Seniority

Junior

High School1 yr expExperience acceptedEnglish

Job Description

Patient Access Representative – Notification of Admission

Guidehouse

• 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.

Job Requirements

  • 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.

Benefits

  • 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

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