Providence Health & Services

Claims Appeals Representative *Remote - Part Time Day shift*

LocationSanta Rosa/California
Employment typePart-Time

This job is now closed

  • Job Description

      Req#: 278861

      Providence is calling a Claims Appeals Representative who will work remotely within our footprint states, AK, CA, OR, WA, TX, NM, or MT.

      The Claims Appeal Representative 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

      Providence caregivers are not simply valued – they’re invaluable. Join our team at Revenue Cycle Business Services 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:

      • 3 years of familiarity with managed care contracting, provider operations and/or payer operations. Experience in negotiations preferred.
      • 3 years of Patient Accounting experience in a physician office, acute hospital, or medical collections.
      • 3 years of Billing collections, or denials management experience and medical terminology.
      • 3 years of experience in medical management computer applications.

      Preferred qualifications:

      • Associate's Degree Or equivalent educ/experience
      • 1 year of experience specifically with Epic applications.

      Salary Range by location:

      NorCal (Napa, Sonoma)
      Min: $25.72, Max: $40.13

      Southern California, NorCal (Humboldt)
      Alaska (Kodiak, Seward, Valdez)
      Min: $22.93, Max: $35.77

      WA Puget Sound
      Oregon (Portland)
      Alaska (Anchorage)
      Min: $22.00, Max: $34.31

      Oregon (Hood River, Medford, Seaside)
      Min: $20.50, Max: $31.99

      Eastern Washington (Richland, Spokane, Walla Walla)
      Min: $19.57, Max: $30.53

      Min: $17.71, Max: $27.63

      Min: $16.78, Max: $26.17

      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 of caring for everyone, especially the most vulnerable in our communities.

      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 the company

      Providence Health & Services is a not-for-profit, Catholic health care system operating multiple hospitals across seven states, with headquarters in Renton, Washington. The Providence affiliate family includes: Covenant Health, Facey Medical Group, Kadlec, Pacific Medical Centers and Swedish Health Services.