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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
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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