Billing and Patient Services Representative

Carolmilgardbreastcenter; Tacoma (WA); On-site; USD 27,552 - 33,062; Full time

Benefits offered by this job

Generous PTO

9 holidays + rollover

401(k) with employer match

Annual pay increases

Full benefits: medical, dental, vision

Job summary

Carolmilgardbreastcenter is seeking a Billing/AR support specialist to address complex patient inquiries and resolve billing-related issues across eligibility, claims, denials, appeals, and patient balances.

The role involves handling calls and emails, collaborating with the Billing and AR Manager, and offering multiple payment options while maintaining HIPAA confidentiality.

Qualifications

• High School Diploma or GED required.
• Associate's degree or equivalent with 1 year of related experience preferred.
• Knowledge of insurance industry trends and regulatory considerations.
• Excellent verbal communication and customer service skills.

Responsibilities

• Address complex patient inquiries across eligibility, claims, denials, appeals, refunds, and collections.
• Log and track appeals by contacting payers for disposition updates.
• Resolve billing issues and ensure accurate, timely billing processes.
• Respond to patient calls and emails professionally and promptly.
• Assist patients with alternative payment options when needed.
• Maintain confidentiality per HIPAA and collaborate with teammates.

Skills

Verbal communication

Customer service

Teamwork

Organization

Multitasking

Attention to detail

Education

High School Diploma or GED

Associate's degree or equivalent

Job description

Job Summary

This position is responsible for addressing and resolving complex patient inquiries, concerns, and billing-related issues across various areas including eligibility, claims, denials, appeals, patient balances, collections, and financial assistance. It includes receiving, responding to, and directing member phone calls and emails. The role works under the supervision of the Billing and AR Manager and requires some knowledge of billing and the healthcare field. Work involves meeting the needs of patients by offering multiple options and solutions.

Pay and Benefits

Pay: $19.54 - $23.77 per hour based on relevant experience, skills, and abilities.

Benefits Highlights

• Generous PTO: Up to 17 days/year for new employees + 9 holidays + rollover
• 401(k): 3% automatic employer contribution + 3% match
• Annual pay increases
• Full benefits: Medical, dental, vision, life, disability, mental wellness
• For more detailed benefits synopsis visit tranow.com/about/careers

Location

This role sits out of our TRA Administrative office in Downtown Tacoma, WA. Free, secured parking is included with this role and location.

Schedule

1.0 FTE - 40 hours - Monday - Friday - 8:30AM - 5PM

Essential Job Functions

1. Address complex patient inquiries, questions and concerns in all areas including eligibility, claims, denials, appeals, refunds, authorizations, collections, price quotes, financial assistance and grant matching.
2. Log and track appeals, re-openings and reconsiderations by contacting payers to gather information and communication on the disposition of claims.
3. Resolve billing operational issues such as missing authorizations, retro-authorizations, front desk errors or missing/incomplete information in hospital files.
4. Conduct pertinent research to evaluate and respond to denials in accordance with established regulatory guidelines.
5. Review pending collection accounts and work daily updated as needed from third party collections office.
6. Process updates/changes/corrections in billing system to support an accurate, timely and complete billing process.
7. Receive, respond to, and direct patient phone calls/emails professionally and promptly.
8. Assist patients in setting up alternative payment options when necessary.
9. Work collaboratively with teammates and other departments.
10. Check email throughout the day to provide timely feedback to patient and outpatient office needs.
11. Utilize knowledge of insurance billing, claims processing, ICD-10, CPT and HCPCS coding to effectively carry out your responsibilities.
12. Perform other duties as assigned.
13. Provide available information upon request and elevate issues/complaints as necessary to the Billing and AR Manager.
14. Check work e‑mail daily.
15. Maintain confidentiality of all center and patient information at all times, as required by facility policy and HIPAA guidelines.
16. Follow the center exposure controls plan for blood borne and airborne pathogens.
17. Perform all other related duties as assigned.

Qualifications

Education/Work Experience

• High School Diploma or GED required
• Associate's degree or equivalent, minimum 1-year recent work experience in related area preferred

Job Knowledge/Skills

• Knowledge of insurance industry trends, directions, major issues, regulatory considerations and trendsetters.
• Knowledge and understanding of state and federal laws and regulations affecting insurance practices.
• Knowledge of activities, practices, and tools for claims adjustment practices.
• Knowledge of how to locate policy information and how to interpret policy language as it applies to specific claims.
• Knowledge of specific principles and practices of negotiation and settlement of claims.
• Knowledge of medical records systems applications.
• Ability to work effectively in a teamwork environment and have respectful behavior while working as a team with co-workers.
• Must possess excellent verbal communication skills; good organization skills.
• Ability to demonstrate effective customer service skills.
• Communicate professionally with other medical facilities, patients, and customers.
• Ability to manage multiple tasks and carry out instructions effectively.

Physical Requirements

Work is classified as sedentary in physical requirements. Requires the ability to lift/carry 1-5 pounds frequently, occasionally 10 pounds maximum.

Mental Requirements

Work requires high attention to detail and the ability to handle mentally stressful situations. The ability to maintain high level of sensitivity towards confidential information is also required.

Working/Environmental Conditions

Work environment consists of normal office or administrative working conditions.