Swedish Health Services Insurance Representative lI - Central Business Services in Seattle, Washington
Swedish Medical Group is looking for an Insurance Representative II (1.0 FTE, Day Shift) to work in the Central Business Services in Seattle, WA.
The Insurance Representative II is responsible for following up on insurance denials and aged claims, submitting claims to secondary payers, and ensuring accurate billing information is submitted. Answer all information requests from payers, and tracing all claims to payers making sure they have been paid or denied appropriately in a timely manner.
In this position you will:
Complete online work lists identifying aged insurance claims for which payment is outstanding and collect outstanding funds through communication with third party payers
Resolve third party denials through appropriate research of carrier specific billing guidelines and through validation of correct billing information being submitted
Appeal claims that have either been denied or paid incorrectly either via phone, on-line or in writing dependent on the unique requirements of the payer
Respond to communication from third-party payers with requests for information or follow-up
Collect and review medical documentation on unpaid claims to ensure compliance with Federal and State billing guidelines. Confer and collaborate with Coding and Compliance Department as necessary
Re-submit claims to third party payers ensuring that accounts are billed appropriately by auditing charges to ensure accurate procedure codes, billing data, and patient information submitted. Obtain correct information and update system when billing information is incorrect or missing
Required qualifications for this position include:
High school diploma or GED equivalent.
General knowledge of bookkeeping, basic accounting, and familiarity with insurance industry practices.
Comprehensive knowledge of CPT and ICD10 codes.
Minimum of two years related work experience in a health care environment.
Demonstrated knowledge of managed care principles, insurance industry practices, and medical terminology required.
About Swedish Medical Group
Swedish Medical Group (SMG) is a successful, performance-driven division of Swedish Health Services, the largest non-profit health provider in the Greater Seattle area. The SMG network includes more than 900 providers across more than 130 primary care and specialty care clinics.
We offer a full comprehensive range of benefits — see our website for details
Our Mission is to improve the health and well-being of each person we serve.
Our Vision is Health for a Better World.
Swedish is the largest not-for-profit health care system in the greater Seattle area. It is comprised of five hospital campuses (First Hill, Cherry Hill, Ballard, Edmonds and Issaquah); emergency rooms and specialty center in Redmond (East King County) and the Mill Creek area in Everett; and Swedish Medical Group, a network of more than 128 primary care and specialty care locations throughout the greater Puget Sound area. Swedish employs nearly 13,000 caregivers (all employees), including nearly 1,400 providers. 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: Bank Of America Bldg (WA239) 800 Fifth Ave Seattle, 98104
Req ID: 292712