Company Overview
Job Family: Patient Financial Services (PFS) Billing
Location: Hybrid (partially remote) – Must be based near San Marcos, CA or El Segundo, CA
Travel Required: None
Security Clearance Required: None
Overview
Guidehouse is currently hiring a Medical Biller to support our Patient Financial Services team. In this role, you’ll manage end-to-end billing functions including initial and secondary claims processing and follow-up on both government and commercial payer audits. Collaboration with internal teams is essential to achieving departmental and organizational goals. You will play a key role in identifying billing challenges, supporting compliance efforts, and streamlining claims processes.
Key Responsibilities
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Manage billing for hospital claims, including correcting and submitting electronic and paper claims
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Process claim adjustments and manage billing reconciliations
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Download and reconcile claims daily from the patient accounting system
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Resolve billing edits and manage claim release or appropriate departmental holds
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Consolidate accounts as needed based on admission timelines
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Submit corrected claims based on audits, diagnosis updates, or DRG changes
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Maintain and update patient records with current insurance and demographic information
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Handle claim denials and audit reports promptly (within 48 hours)
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Monitor trends in denials or billing issues and escalate concerns as needed
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Ensure compliance with federal and state regulations, including HIPAA
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Accurately document all activity in billing and accounting systems
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Provide excellent support to both internal and external stakeholders
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Respond to all calls and emails within 24 hours
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Participate in relevant training and complete special projects within deadlines
Qualifications
Minimum Requirements:
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High school diploma or GED OR a minimum of 3 years of relevant work experience
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0–2 years of experience in healthcare, billing, insurance, finance, or customer service
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Basic understanding of insurance claims processing, coding, and claim follow-up
Preferred Skills:
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Experience in hospital billing
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Proficient in Microsoft Excel and Word
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Strong verbal, written, and interpersonal communication skills
Compensation
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Annual salary: $38,000 – $63,000, based on qualifications and experience
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Eligible for performance-based discretionary bonuses
Benefits
Guidehouse offers a competitive and comprehensive benefits package, including:
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Health, prescription, dental, and vision insurance
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Paid holidays and sick leave
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401(k) retirement plan with company match
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Paid parental leave
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Life and disability insurance
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Flexible spending accounts and health savings accounts
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Tuition reimbursement and learning opportunities
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Employee referral program
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Corporate-sponsored events and community outreach
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Emergency backup childcare
About Guidehouse
Guidehouse is committed to fostering an inclusive, diverse, and supportive workplace. We are proud to be an Equal Opportunity Employer and consider all qualified candidates, including veterans and individuals with disabilities. We comply with all applicable regulations, including the Los Angeles and San Francisco Fair Chance Ordinances.
To ensure a secure hiring experience, all Guidehouse communications regarding recruitment will originate from official domains (e.g., @guidehouse.com or guidehouse@myworkday.com). We will never request banking information or require any payment during the recruitment process.
If you require accommodations during the application process, please contact our team at 1-571-633-1711 or email RecruitingAccommodation@guidehouse.com. Your privacy and confidentiality will be respected throughout.
About the Job
Department: Patient Financial Services (PFS) Billing
Location: Hybrid (partially remote) – Must reside near San Marcos, CA or El Segundo, CA
Travel Required: None
Security Clearance: Not Required
Position Summary
Guidehouse is seeking a dedicated Medical Biller to join our Patient Financial Services team. In this role, you will be responsible for the full spectrum of billing operations, including initial and secondary claims submission, audit follow-up, and resolution of billing issues for both government and commercial payers. Your ability to collaborate with internal departments will be key to meeting organizational goals and maintaining compliance with payer and regulatory standards.
Primary Responsibilities
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Submit and correct electronic and paper hospital claims
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Manage billing adjustments and account reconciliations
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Reconcile and transmit claims from patient accounting systems daily
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Review and resolve claim edits, and manage claim holds as needed
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Merge accounts based on admission timing when appropriate
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Resubmit corrected claims post-audit, diagnosis changes, or DRG updates
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Keep patient records updated with accurate insurance and demographic information
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Process denials and payer audits within 48 hours of receipt
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Identify and escalate patterns in denials or billing issues
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Ensure compliance with HIPAA and state/federal billing regulations
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Document all billing activities accurately in applicable systems
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Handle internal and external inquiries professionally, responding within 24 hours
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Attend required trainings and complete projects within assigned deadlines
Qualifications
Minimum Requirements:
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High school diploma or GED or 3+ years of directly related experience
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0–2 years of experience in healthcare, billing, insurance, finance, or customer service
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Fundamental knowledge of claims processing, coding, and claims follow-up
Preferred Qualifications:
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Previous experience in hospital billing
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Proficiency with Microsoft Word and Excel
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Excellent verbal and written communication skills
Compensation
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Salary Range: $38,000 – $63,000 annually (commensurate with experience and qualifications)
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Eligible for discretionary performance-based bonuses
Benefits
Guidehouse offers a robust and flexible benefits package, including:
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Medical, prescription, dental, and vision coverage
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Paid holidays and personal sick leave
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401(k) with company matching contributions
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Paid parental leave
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Basic and supplemental life insurance
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Short-term and long-term disability coverage
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Health savings and flexible spending accounts
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Tuition reimbursement and professional development programs
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Employee referral incentives
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Participation in corporate-sponsored events and community initiatives
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Emergency backup childcare assistance
About Guidehouse
At Guidehouse, we value diversity, inclusion, and equal opportunity. We welcome applicants from all backgrounds, including veterans and individuals with disabilities. We are committed to following fair hiring practices, including compliance with the Los Angeles and San Francisco Fair Chance Ordinances for individuals with criminal histories.
All recruitment communications will come from a Guidehouse domain (e.g., @guidehouse.com or guidehouse@myworkday.com). We will never request sensitive personal information such as banking details or charge fees at any stage of the hiring process.