Job Family:
Patient Account RepresentativeTravel Required:
NoneClearance Required:
NoneWhat You Will Do:
The CDU Education SME (or CDU Trainer) will complete processes of denials follow - up and reporting with claim understanding. CDU Education SME will prepare reporting for finding trends and account guidance with sharing education to teams. CDU Education SME will review denial CARC codes for presenting denials with education focus. Primarily train both new team members & current team members to denials follow - up processes. The CDU Education SME will facilitate resolution by referring the matter to the appropriate subject matter expert. Escalate matters to supervisors and request the appropriate information or take action so that the issue can be effectively resolved. The CDU Education SME will also do the following:
Perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure.
Communicates issues to management timely and performs other duties assigned by direct supervisors.
Communicate with other organizational departments to ensure proper handling of patient accounts.
Resubmit Corrected Claims and supporting documentation needed for the patient experience.
What You Will Need:
HS Diploma/ GED OR 3 years of relevant experience in lieu of education
3+ Years of working experience in medical specialty billing
Strong Claims Understanding - Clean Claim, UB 04 Format, 1500 Format.
Strong 835 Remittance Understanding.
Working Experience of CARC Codes.
Ability to prepare training documentation & presentation skills
What Would Be Nice to Have:
Professional client engagement experience.
Ability to interpret and apply reimbursement aspects of managed healthcare contracts.
Effective and efficient problem solving.
HIPAA Knowledge.
Strong Lines of Communication.
Self - Motivated to gain knowledge of processes and denials reporting.
Microsoft Office Knowledge.
Ability to Communicate in Group Setting with Professional Leadership Communication.
Time Management Skills.
Organizational Skills.
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The annual salary range for this position is $44,000.00-$74,000.00. 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 Program
About Guidehouse
Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities 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.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of and will not be obligated to pay a placement fee.
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