[Hiring] Patient Access Representative – Notification of Admission @Guidehouse

Role Description

The Patient Access Representative – Notification of Admission Specialist supports Guidehouse’s healthcare revenue cycle operations by completing accurate, timely payer notifications for inpatient and observation admissions. This role helps protect reimbursement, reduce avoidable authorization and notification-related denials, and support consistent performance across client revenue cycle operations. This position works in a 100% remote environment.

• 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.

Qualifications

• 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.

Requirements

• Experience performing Notification of Admission, prior authorization, utilization management support, or payer notification activities.
• Experience working in hospital electronic medical record systems, including Epic and/or Meditech.
• Experience supporting healthcare managed services, revenue cycle operations, patient access, insurance verification, or authorization services.
• Knowledge of denial prevention, payer escalation, notification compliance, and standard work discipline.
• Experience working independently and maintaining productivity in a hybrid or remote work environment (specifically a healthcare services environment).
• Associate degree or higher in Healthcare Administration, Business Administration, or a related field.

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