Interested in working with talented people to help develop innovative solutions to some of society's most complex and challenging problems? We are Guidehouse, a leading consulting firm serving the public sector and commercial clients with specialized capabilities in strategy, technology, and risk management. You may not yet know our name, but we have a rich history. Guidehouse is a combination of PwC's former public sector practice and Navigant's deep expertise in energy, financial services and healthcare.
We offer an exciting, fast-paced environment that fosters intellectual growth and rewards individuals based on impact, not tenure. Our firm is at the forefront of an emerging model solving complex problems that stretch across government and private companies, affording our people the opportunity to be on the cutting edge of the consulting profession. By focusing on markets facing transformational change, technology-driven innovation, and significant regulatory pressure, our employees also develop and deploy world class knowledge and problem solving that leads to breakthrough solutions.
Our healthcare segment is comprised of consultants, former provider administrators, clinicians, and other experts with decades of strategy, operational/clinical consulting, managed care services, digital health, revenue cycle management, and outsourcing experience. Professionals collaborate with hospitals and health systems, physician enterprises, payers, government, and life sciences entities, providing performance improvement and business process management solutions that help them meet quality and financial goals. You will make an immediate impact from day one, working with a team to provide end-to-end solutions. We don't simply put band-aids on our client's issues, we are working side-by-side with them. Are up for the challenge?
Business Process Management unites the strengths of four category-leading companies to address the complexities of today's healthcare system. We design, develop and implement integrated, patient-centered solutions for sustained improvements in performance and profitability, working collaboratively across a spectrum of customers that encompasses hospitals, health systems, physician practice groups and payers.
The Charge Clearance Representative II under general supervision and in accordance to UAHSF established policies & procedures, reviews and codes medical documents and/or charge tickets as assigned. Identifies, documents and provides follow up on deficiencies. Processes edits/denials and makes necessary corrections. Performs all other duties as required.
Must be self-directed / self-motivated; must have good communication and interpersonal skills.
Must be detail oriented.
Work independently; accept responsibility for the direction, control and planning of one's own work.
Recognize the rights and responsibilities of patient and employee confidentiality.
Perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure.
Adaptable to change and improvement.
Relate to others in a manner which creates a sense of teamwork and cooperation.
Show exemplary attitude in levels of maturity, responsibility, judgment and conduct.
Exhibit flexibility and cope effectively in an ever-changing, fast-paced healthcare environment.
Perform effectively when confronted with emergency, critical, unusual or dangerous situations.
Communicate effectively with people from every socioeconomic, cultural and educational background.
Demonstrate the quality work ethic of doing the right thing the right way.
Identify Charge Entry Errors.
Reviews encounter to determine the appropriate action required.
Evaluates medical records documentation to determine correct coding.
Determines if accident date/type is applicable.
Inspects each encounter for missing information and follows up with the appropriate party.
Examines documents in various for missing information.
Resolves Work files via reconciliation dashboard.
Monitor multiple systems for actionable requirements.
Provides liaison/departmental contacts with facts to help clear edits.
Notifies management of any delays when documents are not received in a timely manner as determined by guidelines.
Maintains open channels of communication.
Informs others as needed in a clear, concise manner; selects the proper mode of communication and includes appropriate parties.
Verifies all written communication is grammatically correct and free of typographical errors.
Answers phone and take complete, accurate messages. Make sure messages are routed to appropriate person in a timely manner.
Notifies supervisor promptly when problems arise with equipment, programs, etc.
Performs a Variety of clerical support functions, which may include some or all of the following:
Maintain copier, printer, or other equipment
Mail & stock supplies
High school diploma or equivalent.
2 years' experience with medical billing, coding, and/ or medical records.
Excellent written and oral communication skills required.
Basic computer skills.
College degree or relevant coursework may substitute for part of experience requirement.
Successful completion of all computer classes relating to charge capture & reconciliation is required.
A maximum of two attempts will be given.
Failure to pass all computer classes by the second attempt will result in termination of employment.
Must consistently meet or exceed all MSO/IDX standards set by organization. Must be able to type 40-50 words per minute or complete 8,000-10,000 keystrokes per hour.
Possess advanced knowledge of PC applications, software, and database management.
Be able to perform math & bookkeeping skills.
Possess exceptional telephone & customer service skills; and be knowledgeable and proficient with English grammar & punctuation.
Knowledge of ICD, CPT coding and insurance guidelines
Strong conceptual, as well as quantitative and qualitative analytical skills
Work as a member of a team as well as be a self-motivator with ability to work independently
Constantly operates a computer and other office equipment to coordinate work
Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data
Generally works in an office environment
This position requires successful completion of a background check and employment verification.
The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described.
Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, 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 RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
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.
Rewards and Benefits
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.
With a unique blend of large firm resources and an entrepreneurial collaborative culture, Guidehouse is where your purpose, passion, and expertise transform organizations. Guidehouse is a leading global provider of consulting services to the public and commercial markets with broad capabilities in management, technology, and risk consulting. We help clients address their toughest challenges with a focus on markets and clients facing transformational change, technology-driven innovation and significant regulatory pressure. Across a range of advisory, consulting, outsourcing, and technology/analytics services, we help clients create scalable, innovative solutions that prepare them for future growth and success. Headquartered in Washington DC, the company has more than 7,000 professionals in more than 50 locations. If you're passionately motivated to make a difference and deliver exceptional work, we invite you to learn more about your career opportunities at www.guidehouse.com