[Hiring] Senior Patient Accounts Representative - Appeals and Denials @Providence

Role Description

Responsible for preparation, editing and submission of accurate and timely insurance claims (electronic and manual) to regulatory payers (including Medicare, Medicaid, L&I, VA, Crime Victims & Healthy Options), for primary, secondary, late charge and corrected claims.

• Reviews and resolves billing edits in EPIC and in claims scrubber system.
• Verifies accuracy of claims submitted to payers.
• Claims process includes reconciling claim runs, creating electronic claim files, and resolving errors.
• Resolve claims editing issues and interact with third party clearinghouse or the claims scrubber vendor to produce clean claims.
• Identifies recurring billing errors and trends and reports them to supervisor when necessary.
• Conduct research / analyze coding errors, document billing issues / trends, and assist with problem solving and solutions.
• Process credit balances due to regulatory payers.

Qualifications

• Coursework/Training: Medical terminology and medical coding training in an accredited school or equivalent on-the-job training in a billing role.
• 1 year of experience in hospital insurance regulatory billing, including Medicare, Medicaid and/or Labor & Industries (L&I).

Requirements

• Bachelor's Degree in Finance, Business Management or health care administration (preferred).
• A strong technical background including experience with automated systems (preferred).
• Experience working with Provider One, MECA, FSS0 and/or CWF (preferred).

Benefits

• Best-in-class benefits designed to support you and your family in staying well, growing professionally, and achieving financial security.
• Comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching.
• Health care benefits (medical, dental, vision).
• Life insurance and disability insurance.
• Time off benefits (paid parental leave, vacations, holidays, health issues).
• Voluntary benefits and well-being resources.