PATIENT ACCOUNT REPRESENTATIVE 3

Updated: about 1 year ago
Location: Seattle, WASHINGTON
Deadline: 26 Jan 2023

Our PATIENT ACCOUNT and SUPPORT SERVICES department has an outstanding opportunity for a full-time PATIENT ACCOUNT REPRESENTATIVE 3.

This individual will:  Perform complex duties related to the patient accounts receivable. Patient accounting functions include billing, follow-up, collections, incoming inquiries, audit resolutions, cash applications, credit balance resolutions, and registration updates.  Manage patient accounts for specific complex patient populations such as, but not limited to patient inquiries and disputes, payer appeals and reconsiderations, specialty billing agreements, i.e., MVA/TPL, ITA Billing, Benefits Exhaust, Grants & Budgets, etc.  Work as a liaison between patients’ insurance and other UW Medicine entities to resolve specialty and complicated billing issues.  Work directly with appropriate medical center, billing departments, patient access and clinical staff as necessary to improve service to patients. Answer questions, resolve concerns and document specific actions taken on individual accounts in the Epic Hospital Billing and/or Professional Billing systems. This position is responsible for considering the status of the entire patient account and for exercising judgment to determine appropriate course of action to bring account to resolution.

RESPONSIBILITIES:
• Make outbound and take inbound calls with patients, their families or representatives, insurance companies, attorneys, corporate clients, etc. in a structured environment working under a set schedule and tight timeframes.
• Independently manage special billing programs and projects such as single case agreements, ITA Billing, Benefits Exhaust, Grants & Budgets, etc.
• Obtain detailed information to assure reimbursement and contract adherence for case rate and specialty billing programs specifically negotiated on behalf of UW Medicine.
• Back-up for reconciliation of Payer Escalation Workqueues and spreadsheets.
• Monitor High-Risk Workqueues compliance and fill in for absent staff
• Resolve patient inquiries and disputes referred from Customer Services.
• Payer Appeal and/or Reconsideration review to validate submission is warranted, and composition of claims approved for submission.
• Assist patients or their representatives in understanding their financial obligation and developing solutions to meet their financial responsibilities.
• Communicate with Medical Centers' staff, patients and/or third-party payers as required to obtain or verify billing information, payment, and answer questions or resolve concerns.
• Obtain detailed information from patient and relay information to appropriate medical center, billing department, or patient relations staff as necessary to improve service to patients.
• Research and resolve underpaid accounts.
• Determine and post adjustments to patient accounts in accordance with department procedures.
• Assist in orienting and training new staff.
• Meet deadlines and departmental quality and performance standards.
• Review the status of the entire patient account and exercise judgment to determine appropriate course of action for resolution.
• May maintain spreadsheets and write original correspondence using Microsoft Excel and Word.
• Other duties as assigned.

DESIRED:
Proven ability to compose appeals resulting in favorable results and overturned denials
Knowledge of UB, CMS 1500, ADA and other utilized billing forms and payer requirements.
Knowledge of Epic Hospital Billing and/or Professional Billing, and registration systems.

REQUIREMENTS:
High School graduation or equivalent AND three years of experience in patient accounting, customer service, or a related office environment
OR
Equivalent education/experience.



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