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Patient Access Representative – Notification of Admission
GuidehousePatient Access Representative managing payer notifications for hospital admissions to ensure reimbursements. Collaborating with healthcare teams and maintaining knowledge of payer requirements in a remote setting.
About the role
Key responsibilities & impact- 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.
Requirements
What you’ll need- 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
Comp & perks- 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
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Payer NotificationInsurance VerificationAuthorization ProcessesDocumentation of Payer InteractionsHospital Inpatient WorkflowsObservation WorkflowsQuality Assurance ReviewsTrend AnalysisClient-Specific RequirementsRegulatory Compliance
Soft Skills
CollaborationCommunicationProblem-SolvingAttention to DetailTime Management