Description Providence St. Joseph Health is calling an Account Service Specialist Cycle to work remotely within our footprint states: AK, CA, MT, OR, TX and/or WA. The Account Service Specialist, Denials position is responsible for day-to-day review, coordination and management of technical denials requiring background and understanding from a provider operational and payer logistical perspective. Works closely with the Clinical Denial RN and support staff to review denied accounts, prepare rebuttals, discuss denials with payer representatives and monitor outcomes of follow-up activities. Works closely with the Clinical Denial RN on nuances associated with denials of a clinical nature. Additionally, works closely with Ministry Liaisons within RCS, assuring that payer contracts and Ministry protocols are followed, to promote the development of ongoing value added relationships and sacred encounters between the RCS and the individual Ministries. Represents PSJH from a system perspective when working with payers to challenge and overturn denials of a technical nature. Manages overturn rate data and evaluates trends for improvement opportunities. Routinely communicates trends and other data findings to PFS Manager for consistent and effective feedback to the Ministries and the PSJH Contracting team to assist in developing and implementing processes to maximize collections on denied accounts, as well as improve processes within the ministry to prevent denials from happening. Contributes to the development of all workflows and internal processes of RCS. Works as part of the team to develop meaningful information for Ministries and other stakeholders to improve operational performance and cash collections. Responsibilities:

• Utilize Epic to review and satisfy billing edits, charge information, private or government insurance benefits, and other related information from multiple billing and documentation servers (for multiple hospitals, clinics and insurance companies) while resolving account balances and removing barriers to cash flow.
• Ensure appropriate use of adjustment codes and activity codes to allow for appropriate workflow and trending.
• Proactively identify opportunities to improve business results and/or to alert business units of trends, anomalies or health plan rules and decisions, etc. that need attention.
• Escalate unresolved issues appropriately, quickly and recommend solutions to minimize future problems.
• Must be able to meet primary productivity and performance standards.
• Make appropriate decisions on account activity consistent with approved authority levels.

Required Qualifications:

• Coursework/Training - College level coursework.
• 2 years Experience in automated, computerized account follow-up system in a hospital setting, health insurance claims processing or medical office.

Preferred Qualifications:

• Epic experience.

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 of caring for everyone, especially the most vulnerable in our communities. Salary Range: NorCal (Napa, Sonoma) Min:$22.69, Max: $35.34 Southern California, NorCal (Humboldt) Alaska (Kodiak, Seward, Valdez) Min:$20.22, Max: $31.50 WA Puget Sound Oregon (Portland) Alaska (Anchorage) Min: $19.40, Max: $30.22 Oregon (Hood River, Medford, Seaside) Min: $18.08, Max: $28.17 Eastern Washington (Richland, Spokane, Walla Walla) Min: $17.26, Max: $26.89 Montana Min: $15.62, Max: $24.33 Texas Min: $14.80 , Max: $23.05 About Providence At Providence, our strength lies in Our Promise of \xe2\x80\x9cKnow me, care for me, ease my way.\xe2\x80\x9d Working at our family of organizations means that regardless of your role, we\xe2\x80\x99ll 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 Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise. 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. We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business. We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment. Requsition ID: 171688 Company: Providence Jobs Job Category: Billing/Collections Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Admin Support Department: 4001 SS RC COMMER DENIALS Address: OR Portland 4400 NE Halsey St Pay Range: $19.40 - $30.22 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. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate 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.