Billing and Patient Services Representative

Downtown Tacoma•Tacoma, WA

1d•Onsite

About The Position

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. Responsible for receiving, responding to, and directing member phone calls and emails. Works under supervision of Billing and AR manager. Requires some knowledge of billing and healthcare field. Work requires meeting the needs of the patients by offering multiple options and solutions.

Requirements

High School Diploma or GED required
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 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.
Requires the ability to lift/carry 1-5 pounds frequently, occasionally 10 pounds maximum.
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.

Nice To Haves

Associates degree or equivalent, minimum 1-year recent work experience in related area preferred

Responsibilities

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