Patient Account Representative 2

FHLB Des Moines; Seattle, Northern (WA, KY); Hybrid; USD 32,000 - 46,000; Full time

Job summary

UW Medicine’s Patient Financial Services is seeking a Patient Account Representative 2 for a 40-hour day shift. You will edit and submit billing forms, analyze unresolved claims, perform claim follow-up, and resolve payer denials to keep patient accounts current.

Responsibilities include reviewing accounts, processing AR adjustments, researching credits, verifying eligibility, updating demographics, and communicating with staff and payers to ensure accurate reimbursements.

Qualifications

• High School graduation or equivalent AND two years of experience in patient accounting, customer service, or a related office environment.

Responsibilities

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

Education

High School diploma or equivalent

Job description

Job Description UW Medicine’s Patient Financial Services has an outstanding opportunity for a Patient Account Representative 2.

WORK SCHEDULE 40 hours per week Day Shift

PRIMARY JOB RESPONSIBILITIES

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

REQUIREMENTS

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

DESIRED

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. Related office environments include 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 UW MEDICINE – WHERE YOUR IMPACT GOES FURTHER

UW Medicine is Washington’s only health system that includes a top-rated medical school and an internationally recognized research center. UW Medicine’s mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow’s physicians, scientists and other health professionals. All across UW Medicine, our employees collaborate to perform the highest quality work with integrity and compassion and to create a respectful, welcoming environment where every patient, family, student and colleague is valued and honored. Nearly 29,000 healthcare professionals, researchers, and educators work in the UW Medicine family of organizations that includes: Harborview Medical Center, UW Medical Center - Montlake, UW Medical Center - Northwest, Valley Medical Center, UW Medicine Primary Care, UW Physicians, UW School of Medicine, and Airlift Northwest. Become part of our team. Join our mission to make life healthier for everyone in our community.

COMPENSATION, BENEFITS AND POSITION DETAILS

• Pay Range Minimum: $23.41 hourly
• Pay Range Maximum: $33.47 hourly
• Other Compensation:
• Benefits: For information about benefits for this position, visit https://www.washington.edu/jobs/benefits-for-uw-staff/
• Shift: First Shift (United States of America)
• Temporary or Regular? This is a regular position
• FTE (Full-Time Equivalent): 100.00%
• Union/Bargaining Unit: SEIU Local 925
• Nonsupervisory

ABOUT THE UW

Working at the University of Washington provides a unique opportunity to change lives – on our campuses, in our state and around the world. UW employees bring their boundless energy, creative problem-solving skills and dedication to building stronger minds and a healthier world. In return, they enjoy outstanding benefits, opportunities for professional growth and the chance to work in an environment known for its diversity, intellectual excitement, artistic pursuits and natural beauty.

OUR COMMITMENT

The University of Washington is committed to fostering an inclusive, respectful and welcoming community for all. As an equal opportunity employer, the University considers applicants for employment without regard to race, color, creed, religion, national origin, citizenship, sex, pregnancy, age, marital status, sexual orientation, gender identity or expression, genetic information, disability, or veteran status consistent with UW Executive Order No. 81. To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 or [e-mail]. Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or current investigations related to sexual misconduct at their current employment and past employment. Disclosure is required under Washington state law.