The Department of Laboratory Medicine serves as a regional resource for clinical laboratory services required for patient care, research and educational programs in laboratory medicine. The department now employs 900 people who work at the award-winning University of Washington Medical Center (ranked among the top medical centers in the United States as rated by U.S. News & World Report), Harborview Medical Center (the region's only Level I Trauma center, known for innovations and excellence in trauma care and its centers of emphasis: Trauma, Burn, Neurosciences, AIDS/STD CARER, and mentally- and medically- vulnerable populations.), and many other clinical and research facilities in the area. The University of Washington (UW) is proud to be one of the nation's premier educational and research institutions. Our people are the most important asset in our pursuit of achieving excellence in education, research, and community service. Our staff not only enjoys outstanding benefits and professional growth opportunities, but also an environment noted for diversity, community involvement, intellectual excitement and natural beauty.
The Department of Laboratory Medicine has an outstanding opportunity for full-time, day shift, FINANICAL ACCESS SPECIALIST LEAD on our Reference Lab Client Account Services team located at Columbia Center in Downtown Seattle. The Client Account Services team performs authorization, customer service, revenue cycle and billing related functions for the UW Medicine Reference Laboratory. Under general direction, this position regularly assigns, instructs, and checks the work of others, trains and orients staff, provides feedback on employee performance, as well as identifies and resolves problems.
This position will support both Patient Account Representatives (PARs) and Financial Access Specialists (FASs) across the Client Account Services team. However, the primary responsibilities will be to support PARs performing order entry, error processing, third-party billing/follow-up (commercial and government payers), and patient inquiries (including call center).
Participate in interviewing applicants and training and orienting new employees to department
Review and correct the work performed by others for compliance with established procedures
Monitor and evaluate policies and procedures; recommend changes as necessary
Review work and provide instruction to improve efficiencies and accuracy in account resolution and to ensure compliance with established procedures
Schedule and adjust staffing coverage as needed
Participate in and/or lead special project work
Assign and prioritize work for employees on a daily/weekly basis
Monitor Client Account Services call center and adjust staffing as needed and prepare performance reports for Supervisor
Prepare and review productivity logs and send summary to Supervisor
Attend continuing education workshops and other training activities to keep up to date with current hospital practices and payer requirements
Handle a high volume of calls with patients, their families or representatives, insurance companies, attorneys, corporate clients, etc. in a structured environment working under a set schedule and tight timeframes
Research, resolve and respond to patient inquiries
Obtain detailed information from patient and relay information to appropriate medical center, billing department, or patient relations staff as necessary to improve service to patients
Coordinate with self-pay and collection outsourcing partners to help resolve patient issues and/or communicate outcomes
Using resource materials such as payer/provider instruction manuals, provider bulletins, Laboratory Medicine policies and procedures, audit information on third-party claim forms for accuracy and completeness, to ensure submission of clean claims
Use available payer resources to verify eligibility and/or expedite resolution of rejections and denials
Perform billing, guarantor account, coverage and demographic updates to assist in securing payment for services in an accurate and timely manner
Analyze reimbursement for accuracy
Identify systemic payer or provider issues and either resolve or escalate to management for resolution, particularly in relationship to third-party payer denials
Obtain insurance authorizations through assigned payer administrators
Verify/document patients eligibility and benefits in XIFIN
Prepare estimates of fees upon request for client, patients and third-party payers for lab tests requiring prior authorization
Review payment options with patients
Provide internal customers on-going status of inpatient/outpatient authorization by payer
Keep daily productivity log as assigned
Process payments using XIFIN
Call patients to provide overview of limited medical benefits and Out-of-Pocket cost
Prepare and/or facilitate the coordination of Notice of Non-Coverage forms for patient signature
Call referring providers to obtain orders or to initiate authorization
Coordinate and explain options to patients related to potential financial responsibilities including Financial Assistance, possible Medicaid eligibility, financial implications of proceeding with or without authorizations, and in and out-of-network ramifications
Confer with Financial Access Specialist Supervisor if coverage status unclear or other information unclear
Interpret Laboratory Medicine policies, procedures and services to patients, Financial Access Specialists and Patient Account Representatives
Perform related duties as required
This position provides opportunities to work in a fast-paced, challenging, diverse and rewarding environment. As an employee you will enjoy generous benefits and work/life programs. For detailed information on Benefits for this position, click here.
REQUIREMENTS: High School diploma or GED certificate plus three years of experience in a medical office setting. OR Equivalent education/experience.
Familiarity with medical/laboratory/patient insurance billing and account receivable education/experience.
Knowledge of medical terminology, CPT billing codes, and ICD-10 diagnosis codes
Experienced customer service relations
Excellent verbal and written communication skills
Experience leading others
Excellent typing and 10-key skills
Experience using SunQuest, XIFIN, Epic or other medical clinical information and billing systems
Founded in 1861, the University of Washington is one of the oldest public institutions in the west coast and one of the preeminent research universities in the world. The University of Washington is a multi-campus university comprised of three different campuses: Seattle, Tacoma, and Bothell. The Seattle campus is made up of sixteen schools and colleges that serve students ranging from an undergraduate level to a doctoral level. The university is home to world-class libraries, arts, music, drama, and sports, as well as the highest quality medical care in Washington State and a world-class academic medical center. The teaching and research of the University’s many professional schools provide undergraduate and graduate students the education necessary toward achieving an excellence that will serve the state, the region, and the nation. As part of a large and diverse community, the University of Washington serves more students than any other institution in the Northwest.