Patient Billing Specialist II — Claims & Denials

University of Washington; Alaska; Presencial; USD 32.000 - 45.000; Jornada completa

Descripción de la vacante

UW Medicine is seeking a Patient Account Representative 2 to support billing and follow-up activities across UB-04, CMS-1500, and ADA forms. The role emphasizes analyzing unresolved insurance claims, denials, eligibility verification, and payer requirements to optimize reimbursement.

Responsibilities include processing adjustments, updating patient records, and communicating with payers and internal teams. A strong attention to detail and proficiency with Excel and payer portals are valued in

Formación

• High School graduation or equivalent AND two years of experience in patient accounting or a related office environment.
• Equivalent education and/or experience may substitute for minimum qualifications.
• Knowledge of UB-04, CMS 1500, ADA and payer requirements is desirable.
• Experience with payer portals, eligibility verification and claim follow-up.

Responsabilidades

• Edit, prepare, and submit UB-04, CMS-1500, ADA and other forms in compliance with regulations.
• Analyze unresolved insurance accounts, including denied or unpaid claims, and take action.
• Perform insurance claim follow-up by researching status, eligibility, benefits, and authorizations.
• Review denials to determine corrective actions such as rebilling, appeals, or adjustments.
• Assess patient accounts and determine appropriate resolution actions based on history and payments.
• Process Accounts Receivable adjustments per policy and guidelines.
• Analyze credit balances and resolve payer overpayments or posting discrepancies.
• Use payer portals and internal resources to verify eligibility and payment details.
• Update patient demographics and payer information to support accurate submissions.
• Communicate with Medical Center staff and third-party payers to obtain and resolve information.
• Maintain spreadsheets and reports to track workload, payer activity, and reimbursement analysis.

Conocimientos

Customer service

Communication

Attention to detail

Payer follow-up

Herramientas

Excel

Word

Epic Hospital Billing

SBO

Descripción del empleo

UW Medicine is seeking a Patient Account Representative 2 to support billing and follow-up activities across UB-04, CMS-1500, and ADA forms. The role emphasizes analyzing unresolved insurance claims, denials, eligibility verification, and payer requirements to optimize reimbursement.

Responsibilities include processing adjustments, updating patient records, and communicating with payers and internal teams. A strong attention to detail and proficiency with Excel and payer portals are valued in