Overview
**Description**
Monitors the compliance of all major payers with health service contract reimbursement terms and payment provisions. Researches and identifies underpayment patterns and escalates issues to Manager as appropriate. Appeals and resolves insurance underpayments as directed by Manager. Recommends process improvements to maximize coding and billing, and provides support to departments directly responsible for contracting, coding, registration, referral management, revenue posting, and patient financial services. The scope of this position includes patient service revenue generated within Pacific Medical Centers. This position reports to the Revenue Cycle Manager
Providence caregivers are not simply valued – they’re invaluable. Join our team at PacMed Clinics DBA Pacific Medical Centers and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
**Required Qualifications:**
+ 4 years progressive healthcare business office or health insurance experience
+ Experience in healthcare financial services
**Preferred Qualifications:**
+ Associate’s Degree or equivalent educ/experience
+ Equivalent from a two-year college or technical school
**Job Specific Knowledge, Skills, and Abilities:**
+ Knowledge of state and federal regulations and third party contracts pertaining to health care reimbursement required
+ Extensive knowledge of physician payment methodologies and supporting coding systems, such as CPT, HCPCS and ICD10
+ Excellent communication and interpersonal skills with all levels of internal and external customers
+ Ability to communicate technical information to individuals with varying degrees of financial and technical expertise
+ Ability to read, analyze and interpret documents such as general business periodicals, journals, financial reports, government regulations, and procedure manuals
+ Ability to write reports, business correspondence, and protocols
+ Evidence of a work style that creates collegiality, teamwork, participation, communication, and a positive work environment
+ Ability to support decisions by communicating concerns, questions, and recommendations through appropriate channels
+ Ability to maintain confidentiality
+ Ability to use a variety of computer applications including Word, Excel, Power Point, and the PacMed Physician Division’s health information systems
+ Ability to add, subtract, multiply and divide using whole numbers, fractions, and decimals
+ Ability to understand general patient accounting
+ Ability to interpret and develop electronic spreadsheets and reports
+ Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
+ Ability to efficiently manage multiple, concurrent conflicting priorities
+ Ability to analyze data presented for logic and error identification
+ Ability to place detailed data in presentation format
+ Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form
+ Demonstrate competency with all position related software programs
+ Misys, EPIC and MPV Contract Management System experience highly preferred
**Why Join Providence?**
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our mission to advocate, educate and provide extraordinary care.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
**About Providence**
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
**About the Team**
Providence Physician Enterprise (PE) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers.
PE is comprised of Providence Medical Group in Alaska, Washington, Montana and Oregon; Swedish Medical Group in Washington’s greater Puget Sound area, Pacific Medical Centers in western Washington; Kadlec in southeast Washington; Providence’s St. John’s Medical Foundation in Southern California; Providence Medical Institute in Southern California; Providence Facey Medical Foundation in Southern California; Providence Medical Foundation in Northern and Southern California; and Covenant Medical Group and Covenant Health Partners in west Texas and eastern New Mexico.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
**Requsition ID:** 262123
**Company:** Pacific Medical Jobs
**Job Category:** Reimbursements
**Job Function:** Finance
**Job Schedule:** Full time
**Job Shift:** Day
**Career Track:** Admin Support
**Department:** 3060 OTHER FISCAL SERVICES WA
**Address:** WA Seattle 1200 12th Ave S
**Work Location:** PACMED Admin Bh-Seattle
**Pay Range:** $21.54 – $32.31
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
