Hospital Biller - Healthcare Revenue Cycle

Job Family:

Patient Account Representative

Travel Required:

None

Clearance Required:

None

This position is initially in office at our San Antonio, TX office (Monday-Friday, 8AM-4:30PM CT). A hybrid work arrangement may be available after training.

What You Will Do

As a Hospital Biller, you will support accurate and timely billing for inpatient and outpatient hospital services. You will work with government and commercial payers, resolve claim issues, and partner with internal teams to help meet department and facility goals.

You will also identify recurring billing edits, compliance concerns, payment issues, and payer or system trends, then communicate your findings to management. Additional related duties may be assigned as needed.

Key Responsibilities

• Review, correct, and bill electronic and paper claims for primary and secondary payers.
• Download and reconcile claims from the patient accounting system to the electronic billing system each day.
• Transmit or release claims at least daily.
• Work assigned claims daily by resolving edits, validating claim information, or placing accounts on the appropriate departmental hold.
• Follow up on held, unreleased, rejected, and payer-audited claims within required time frames.
• Submit adjusted claims and rebill claims when needed.
• Review same-day and 72-hour admission reports to determine whether accounts should be combined.
• Update patient accounts with corrected demographic or insurance information.
• Communicate address or plan changes to the appropriate team to help maintain the accuracy of the insurance master.
• Monitor denials, billing edits, payments, and payer issues for trends and report findings to the supervisor.
• Complete billing reconciliations and assigned special projects within established time frames.
• Document account activity clearly in the electronic billing and patient accounting systems.
• Follow applicable state and federal billing requirements, including HIPAA standards.
• Participate in training provided by the hospital and third-party payers.
• Respond to internal and external customers professionally and courteously. Return calls and emails as soon as possible and within 24 hours.
• Support the facility mission and values.

What You Will Need

• High School Diploma OR GED OR 3 years of relevant experience in lieu of a diploma or GED.
• 1-3+ years of experience in healthcare, insurance, business, finance, or customer service.
• Working knowledge of one or more of the following areas: insurance claims, billing, coding, follow-up, finance, accounting, or customer service.
• Knowledge of payer requirements and applicable government billing regulations.
• Ability to investigate issues, identify solutions, and communicate recurring concerns to management.
• Strong organization, accuracy, communication, and interpersonal skills.

What Would Be Nice to Have

• Previous hospital billing experience.
• Experience correcting, submitting, and following up on hospital claims.
• Experience using Microsoft Excel and Word.

#IndeedSponsoreed

#LI-DNI

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 [email protected]. 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 [email protected].  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 [email protected]. 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 Guidehouse and Guidehouse will not be obligated to pay a placement fee.