Overview

Virginia Mason Franciscan Health brings together two award-winning health systems in Washington state CHI Franciscan and Virginia Mason. As one integrated health system with the most patient access points in western Washington, our team includes 18,000 staff and nearly 5,000 employed physicians and affiliated providers. At Virginia Mason Franciscan Health, you will find the safest and highest quality of care provided by our expert, compassionate medical care team at 11 hospitals and nearly 300 sites throughout the greater Puget Sound region. While you’re busy impacting the healthcare industry, we’ll take care of you with benefits that include health/dental/vision, FSA, matching retirement plans, paid vacation, adoption assistance, annual bonus eligibility, and more!

Responsibilities

This position is responsible for ensuring clean claims are sent to insurance carriers timely and responses from insurance carriers for services provided are resolved in a timely manner to optimize VMMC revenue generation and cash flow. This position will also complete the processing of inappropriately paid accounts by contacting payers, processing payer correspondence, rebilling, working denials and conducting appeals to obtain the highest possible reimbursement, meet DRO goals, and ensure patient satisfaction. This position will proficiently perform duties in both professional and facility billing platforms.

• Communicates with insurance carriers, patients, both internal and external customers via phone, and written correspondence.

• Working mistake proofing successive checks to ensure clean claims are being sent to insurance carriers.

• Corrects CPT and ICD-10 codes based on recommendation from certified coders, updates registration, conducts batch research, submits dictionary updates (HCPCS).

• Follow-up and reconciliation of accounts both credit and debit.

• Audits records and claims submissions and performs appeals when necessary.

• Obtain retro-authorizations for claims reconsideration

• Root cause analysis, and trend reporting to supervisor to assure mistake proofing measures can be implemented.

Qualifications

• This position requires the ability to maintain current knowledge of assigned payer billing requirements; excellent analytical, problem solving, and communication skills.

• Demonstrated knowledge of medical terminology, billing/collection practices and workflows; basic familiarity with Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10), Tenth Edition codes is preferred.

We are an equal opportunity/affirmative action employer.

Pay Range

$23.00 - $30.99 /hour

We are an equal opportunity/affirmative action employer.