U

University of Washington

Public research university in Seattle, WA

Patient Account Representative 2

Clinical Support & Patient AdministrationPosted on Nov 6
Full-timeSeattle, WA, USA$23.41 - $33.47 /hrRemote

About the Job

Requirements

  • High school graduation or equivalent and two years of experience in patient accounting, customer service, or a related office environment are required.
  • Equivalent education and/or experience may substitute for minimum qualifications except where legal requirements, such as a license, certification, and/or registration, apply.

Responsibilities

  • Edit, prepare, and submit UB-04, CMS-1500, ADA, and other applicable billing forms and electronic claims in accordance with regulatory requirements.
  • Analyze unresolved insurance accounts, including denied, rejected, unpaid, underpaid, suspended, or otherwise unresolved claims, and take appropriate action.
  • Research claim status, payer processing requirements, eligibility, benefits, authorizations, medical necessity requirements, and payment discrepancies to perform insurance claim and account follow-up.
  • Review payer denials and claim rejections and determine appropriate corrective action, including claim correction, rebilling, reconsideration, appeal, adjustment, or other payer follow-up needed to resolve the account.
  • Review the entire patient account and use independent judgment to determine an appropriate course of action, considering claim history, payer responses, payments, adjustments, and outstanding balances.
  • Prepare and/or process Accounts Receivable adjustments in accordance with departmental policies, payer requirements, contractual terms, and established adjustment guidelines.
  • Analyze insurance credit-balance accounts, determine the cause of credit balances, and resolve payer overpayments, duplicate payments, and payment posting discrepancies.
  • Use available systems, payer portals, internal resources, and other reference materials to obtain and verify insurance eligibility, benefits, coverage, authorization, claim status, and payment.
  • Update patient demographic, insurance, and payer information in applicable systems to support accurate claim submission, payer processing, reimbursement, and account resolution.
  • Communicate with Medical Center staff and third-party payers to obtain, verify, and resolve billing, claim, eligibility, authorization, payment, and reimbursement information.
  • Maintain spreadsheets, reports, and other tracking tools for account follow-up, workload management, payer activity, reimbursement analysis, and departmental reporting; use Microsoft Excel, Word, and other applicable software to prepare correspondence and documentation.

Desired Qualifications

  • Knowledge of UB, CMS-1500, ADA, and other utilized billing forms and payer requirements.
  • Knowledge of Epic Hospital Billing and/or SBO (a combination of hospital and professional) billing, and registration systems.
  • Experience in related office environments such as hospital or SBO patient financial services, insurance billing, claims processing and follow-up, claims denials, appeals, underpayments, or other business office settings involving patient account insurance billing and follow-up functions.

About the Company

University of Washington

Public research university in Seattle, WA

The University of Washington is a public research university founded in 1861, with campuses in Seattle, Bothell, and Tacoma. It provides undergraduate, graduate, and professional education alongside research and public service.

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