Patient Access Representative – Notification of Admission

Job Family:

Travel Required:

Clearance Required:

What You Will Do:

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 individual will collaborate with Patient Access, Case Management, Utilization Review, Health Information Management, Payer Representatives, and Guidehouse operational leadership to ensure admissions are appropriately identified, submitted, documented, and escalated through resolution.

This position works in a 100% remote environment.

Job Responsibilities Include:

·       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.

What You Will 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.

What Would Be Nice To Have:

·       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.

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.