Remote Patient Accounts Specialist II

University of Washington; Seattle (WA); Remoto; USD 32.000 - 46.000; Tempo pieno

Descrizione del lavoro

UW Medicine’s Patient Financial Services team at University of Washington seeks a Patient Account Representative 2 to edit and submit UB-04, CMS-1500, ADA forms and handle complex insurance follow-up. You will review denials, perform follow-up, update patient records, and maintain detailed reimbursement reporting.

Join a team dedicated to accurate billing and payer collaboration. The role emphasizes independent judgment on account resolution, communication with third-party payers, and use of

Competenze

• 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

Mansioni

• Edit, prepare, and submit UB-04, CMS-1500, ADA, and other applicable billing forms and electronic claims.
• Analyze unresolved insurance accounts and follow up on claims.
• Review denials and rejections and take corrective action.
• Update patient demographics and payer information in systems.
• Maintain spreadsheets and reports for tracking payer activity and reimbursement analysis.
• Communicate with Medical Center staff and third-party payers to obtain and resolve billing information

Conoscenze

UB-04 forms

CMS 1500 forms

Insurance follow-up

Payer denial review

Excel

Formazione

High School diploma

Strumenti

Epic

SBO

Descrizione del lavoro

UW Medicine’s Patient Financial Services team at University of Washington seeks a Patient Account Representative 2 to edit and submit UB-04, CMS-1500, ADA forms and handle complex insurance follow-up. You will review denials, perform follow-up, update patient records, and maintain detailed reimbursement reporting.

Join a team dedicated to accurate billing and payer collaboration. The role emphasizes independent judgment on account resolution, communication with third-party payers, and use of