Swedish Medical Center Business Office Government Team Lead in Seattle, Washington
Swedish is looking for a Business Office Government Team Lead (1.0 FTE, Day) for Swedish Shared Services located in Seattle, WA.
We are seeking a Business Office Government Team Lead to act as a resource for other Billing Office-Government staff members. In addition to their regular billing and follow-up responsibilities, this individual assists in training new employees and volunteers, promotes and enforces best practices, and sets the standard for all aspects of the job. This person serves as the primary contact in the absence of a supervisor or manager. The Lead assists the department supervisor with employee evaluations, quality and productivity
monitoring, and special projects as needed. The Lead does not hire, terminate, discipline, promote, demote, or transfer employees. The Government Team Lead is responsible for collecting active A/R from Medicaid and Medicare. This individual contacts payers via phone call or online inquiry to resolve unpaid hospital claims. The Lead reviews remaining balances on patient
accounts once payments and adjustments are posted and determines the appropriate next action. The Lead reviews denials by
payer as well as line items to determine if additional follow-up is required or assistance from other departments and forwarded to them as needed, including Care Coordination, Revenue Coordination, Registration, etc. The Government Team Lead works closely with the supervisor to identify and document ongoing payer issues and communicates updates to Government staff members. The Lead utilizes online eligibility systems including EPIC (Real Time
Eligibility), Passport, and One Health Port to determine correct eligibility. This involves writing and submitting appeals, including necessary supporting documentation. This individual updates patient's insurance data in EPIC as required or appropriate. The Lead follows established Billing Office guidelines for adjustments to accounts and forwards to appropriate
work queues when required. The Lead answers phone inquiries from patients and payers regarding bills, charges, and account status. Aids supervisor in the design of systems to support the business and operational needs of Swedish Health Services (SHS). Actively contributes in the development of new workflows, policies and procedures, and documentation for the Government
billing/follow-up team. This person is able to resolve issues and requests related to Government billing/follow-up and perform
other duties as assigned.
In this position you will:
Act as a resource person for other employees within the Government – Billing/Follow-up team. In addition to their regular responsibilities, assist with the training of new employees and volunteers, promote and enforce best practices and sets the standard for all aspects of the job. Serve as a contact person in the absence of a supervisor or manager. Does assist the department supervisor with quality and productivity monitoring as well as special projects when required.
Have knowledge of EPIC Hospital Billing functionality to research patient account information, understand payment history and add insurance.
Complete at least 95% of daily work queue. Ensure that each account has the appropriate documentation and that the insurance companies have all necessary information from Swedish and/or patient for processing.
Review EOB’s with insurance companies when discrepancy is apparent on account. Verifies account balance and requests adjustments when necessary. Also reviews patient balance for any adjustments as necessary.
Have knowledge of payer and billing contracts.
Be able to keep abreast of new/changing legal requirements and to integrate into current procedures in a timely and efficient manner.
Ensure efficient and accurate account collection process inclusive of claim editing and submission.
Work correspondence queue and follows up as needed, i.e., mails or faxes medical records, itemized statements, and UB92 forms, follows up with guarantor on COB updates needed.
Communicate and negotiate effectively with insurance companies and other third parties.
Aid supervisor in the design of systems to support the business and operational needs of Swedish Health Services (SHS).
Actively contribute in the development of new workflows, policies and procedures, and documentation for the department.
Required qualifications for this position include:
High School Diploma or GED.
3 years of experience in hospital billing, including government insurance billing experience.
Medical terminology and medical coding training in an accredited school or equivalent on-the-job training in a billing role.
Knowledge of state and federal regulations as they pertain to billing processes and procedures.
Knowledge of insurance claim processing and third party reimbursement.
Knowledge and detailed understanding of all negotiated agreements.
Knowledge of MS Windows and Office Applications.
Detailed knowledge and understanding of ICD, CPT, and HCPCS coding classification systems, familiar with medical terminology, its applications, insurance rules, and regulations.
Preferred qualifications for this position include:
- A strong technical background including experience with automated systems and proficiency with EPIC.
About Swedish Shared Services
Swedish is the largest, most comprehensive, nonprofit health provider in the Greater Seattle area. Our expanding network of facilities currently includes three hospital locations in Seattle, a hospital in Edmonds and the new Swedish Issaquah campus. It also consists of Swedish Medical Group’s network of primary care clinics, and affiliations with suburban hospitals and specialty clinics throughout Greater Seattle.
Each campus has a local operations leadership team, supported by centrally located and led corporate services, such as Human Resources, Financial and Information Services. .
We offer a full comprehensive range of benefits — see our website for details
Our nonprofit Mission is to improve the health and wellbeing of each person we serve. Our Vision is to demonstrate the highest-quality, best-value healthcare to all we serve.
Swedish is the largest nonprofit health care provider in the greater Seattle area. It is comprised of five hospital campuses (First Hill, Cherry Hill, Ballard, Edmonds and Issaquah); ambulatory care centers in Redmond and Mill Creek; and Swedish Medical Group a network of more than 118 primary care and specialty locations throughout the Puget Sound. Swedish employs more than 13,300 employees and 3,100 physicians and allied health professionals. Whether through physician clinics, education, research and innovation or other outreach, we’re committed to caring for the people in our region and beyond. Swedish is proud to be an Equal Opportunity Employer. Swedish does not discriminate on the basis of race, color, gender, disability, protected veteran, military status, religion, age, creed, national origin, gender identity, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Billing/Insurance
Work Locations: Metropolitan Park East (WA152) 1730 Minor Avenue Metropolitan East Tower Seattle, 98101
Req ID: 233926