Patient Accounts Representative
Patient Accounts Representative
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Job Description
The Patient Account Representative will be responsible for reviewing and auditing billing charges billing collection straightforward coding and all account receivable activities for the physician clinics within Saint Lukes Health System. Activities include but are not limited to entering charge demographics troubleshooting charge related issues raised by clinic staff responding to inbound and outbound billing calls from patients payment posting resolving payment credits identifying and correcting medical claim errors that may prevent payment and identifying correcting and resubmitting medical claims denied by insurance companies. Resolving claim edits working denials and appeals.
Shift Details:Monday Friday Full Time Day
Location: Candidate must reside in the Kansas City Metro area position is work from home.
Responsibilities:
Claim Edits
Responsible for researching patient billing claims to identify and correct coding/claim errors
Responsible for researching patient insurance coverage to identify and resubmit claims to fix coverage denials.
Research and outline documentation needed for respective payor organizations so that claims are processed correctly
Familiarity with NCCI edits incidentals/inclusive and bundling rules etc.
Identify problem trends
Communicate with payors for resolution to complications with claims
Responsible for 277 EDI transactions/rejections
Working with EDI transactions
Payment posting corrections/adjustments and ability to distribute payments
Correct/enter charges
Work with multiple teams/departments to resolve issues
Payment plan or financial assistance coordination
Insurance Denials and FollowUp
Responsible for researching identifying errors and correcting claims denied by insurance companies.
Must be able to asses claim to determine when appropriate to make charge adjustments void a charge or escalate to the team lead and/or another medical billing team.
Responsible for writing appeal letters to insurance companies
Responsible for following up with insurance companies for no response claims.
Responsible for working with patient calls escalated from the Customer Service team regarding involving billing code issues.
Research refund request from payor organizations
Responsible for preliminary audit of billing code errors before claim submitted to the Coding team.
Responsible for routing complex claim denial to team lead and/or the appropriate medical billing team.
Responsible for identifying issues which can be resolved by programing software to prevent denials.
Responsible for becoming a subject matter expert on the payor policies.
Responsible for communicating and resolving problems with the provider representatives
Responsible for simple level coding including diagnosis review modifier applications some CPT cod changes following process documents and payor policies
We are looking for someone with excellent customer service skills. The ideal candidate has strong computer and critical thinking skills and can multitask.
Why Saint Lukes
We believe in creating a collaborative environment while looking for innovative ways to improve. We offer competitive salaries and benefits packages to all eligible employees:
Medical health plans
Tuition reimbursement
Paid time off
Retirement contributions
Employee Assistance Program
Job Requirements
Applicable Experience:
1 yearJob Details
Full TimeDay (United States of America)The best place to get care. The best place to give care. Saint Lukes 12000 employees strive toward that vision every day. Our employees are proud to work for the only faithbased nonprofit locally owned health system in Kansas City. Joining Saint Lukes means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.
Join the Kansas City regions premiere provider of health services. Equal Opportunity Employer.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
