Patient Account Representative for Outpatient Oncology Per Diem Days

CHI Franciscan Health has exciting and rewarding careers with competitive salaries and benefits. We are a family of hospitals, health care services, and medical providers delivering compassionate care to people throughout the South Puget Sound. We are part of Catholic Health Initiatives, one of the largest not-for-profit health care systems in the country.
Our mission is to deliver high quality care that meets our patients' medical needs while providing emotional and spiritual support to patients and their families. We believe this three-part approach €” physical, emotional, and spiritual €” is essential to healing the whole person. Come join our team!
Job Summary:
Submit claims to government agencies, medical service bureaus and insurance companies for Durable Medical Equipment (DME) and pharmacy. Answer all information requests from those payers, and trace all claims to those payers making sure they have been paid or denied appropriately and in a timely manner. Post payments, follow up on insurance rejections, submit claims to secondary insurers, calculate the precise patient responsibility portion to be billed, and respond to patient queries.
Essential Duties:
Ensure patient satisfaction through timely and effective patient account maintenance including assistance with billing, third-party payments, adjustments, information verification and record maintenance.
Submit claims to government agencies, medical service bureaus, and insurance companies ensuring that accounts are billed appropriately by auditing charges to ensure accurate procedure codes, billing data and patient information submitted.
Interpret and communicate information regarding credit policies and procedures, billing practices, insurance submission and out-of-pocket patient responsibility. Keeps abreast of current/revised regulatory requirements (e.g. Medicare/Medicaid) relating to the billing of durable medical equipment, orthotics, prosthetics and related products, as well as pharmacy billing; provides information regarding implementation of new codes and revision of charge documents as requested.
Accurately and timely post private payments, insurance payments, disallows and/or denials to appropriate patient account, calculate patient responsibility, interpret explanation of benefit message codes, identify payment discrepancies by contacting insurance carrier, and determine if rebilling is necessary.
Function as liaison between patients and clinic staff on claims, billing questions or insurance related issues. Provides feedback and in-service training to retail pharmacy and hospital staff with respect to billing/documentation requirements and restrictions on supplies and equipment. Act as a resource to physicians, providers administrators and patients regarding health insurance claim policies, procedures and requirements. Respond to inquiries from agencies, bureaus, and insurance companies to assist in the claim payment process. Effectively process patient, clinic and insurance correspondence, including requests for refunds and collections when warranted
Accurate batch balancing and reporting. Trace errors, record adjustments to proper accounts and determine the appropriate destination for unidentified funds.
Submit claims to secondary insurers as required. Ensure deposits balance to posting and resolve any discrepancies.
Manages monthly renewals of all rental equipment, including notifying appropriate department for pickup due to length of need expiration.
Additional Responsibilities:
Adheres to and exhibits our Core Values of Reverence, Integrity, Compassion and Excellence.
High School Diploma or GED equivalent required.
A basic course in medical terminology, medical billing and/or accounting preferred.
Within the last 18 months, 12 €“ 18 months charge and payment posting experience in a healthcare environment required. Knowledge of insurance companies, CPT and diagnosis codes as well as experience following billed and denied claims.
Knowledge of DME medical billing and reimbursement standards, procedures and documentation
Knowledge of pharmacy billing and reimbursement standards, procedures and documentation
Consistent with our Core Values, Catholic Health Initiatives employers are EEO/AA/M/F/Vets/Disabled Employers. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identification, protected veteran status, disability or any other legally protected characteristic.

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