Escalation Representative Jobs (NOW HIRING)

Job Family:

Travel Required:

Clearance Required:

What You Will Do:

The PAR assists in overseeing the daily operations of assigned project(s). This position is responsible for providing support in developing, implementing, managing, and meeting or exceeding the operational goals of our clients and Company. The PAR will and may work closely with their team, project supervisors, operations managers, and the client to work on opportunities with new and emerging approaches to our clients' business processes. This position will follow and ensure that client and company policies and procedures are followed and will also perform all job-related duties as assigned.

This position offers an attractive hybrid schedule working two days in our Mitchell, SD office and three days virtually from home. 8 hour shift between 8:00 AM - 5:00 PM PT CT.

• Review, submit, and maintain tracking of payer escalations claims.

• Meet with payer escalation representatives monthly (or as required) to review outstanding escalations and identified payer trends & issues.

• Assist with monthly denial review and help lead the denial committee, which will present denials and trends to key client contacts.

• Assist in answering front-line team member questions.

• Develop job aides and SOPs and provide subsequent support and training.

• Aid in basic report generation or review where required.

• Ensure projects and duties are completed within specified deadlines.

• Assume additional duties and responsibilities or special projects based on client and/or business needs.

• Be flexible and adapt quickly to change, embracing new processes and technologies in a positive manner as client or business needs shift.

• All job-related duties as assigned

What You Will Need:

• High School Diploma / GED or 3 years of Relevant Equivalent Experience in Lieu of Diploma / GED.

• 0-2+ year's experience within an office, business, operations, customer service or healthcare field.

What Would Be Nice To Have:

• Previous experience working in insurance portals

• PC skills in a Windows environment.

• Knowledge and utilization of desktop applications to include Word and Excel is essential.

• Ability to initiate and follow through on projects and work independently with minimal supervision

• Billing / Collections experience

#IndeedSponsored

#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 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.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com. 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 recruiting@guidehouse.com. 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.