Patient Accounts Representative SLPG
Saint Luke's Health SystemJob Description
Location: This position is a work from home position, candidate must be located in Kansas or Missouri
Schedule: Flexible Schedule - Monday - Friday: 6:00AM - 6:00PM
Patient Accounts Representative is responsible for reviewing, billing, collection, and accounts receivable activities for the hospital (and in some cases the physician) billing departments within Saint Luke's Health System. Activities include, but are not limited to, entering demographics, troubleshooting issues, responding to inbound and outbound billing calls from patients, payment posting, resolving 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. Patient Account Representative may be responsible for any or all the following duties, including duties not otherwise assigned.
Claim Processing
Responsible for researching patient billing claims to correct claim errors
Understand respective payor requirements so claims are processed correctly
Familiar with NCCI / NCD / LCD edits, incidentals/inclusive, and bundling rules, etc.
Work with multiple teams/departments to resolve issues
Hand billing of specialty care which may include residential care, transplant and research
Insurance Denials
Responsible for researching, identifying errors, and correcting claims denied by insurance companies.
Responsible for writing appeal letters to insurance companies
Research refund request from payor organizations
Responsible for preliminary audit of billing code errors before claim resubmitted from denial
Responsible for becoming a subject matter expert on the payor policies
Payment posting corrections/adjustments and ability to distribute payments
Insurance Follow-Up
Responsible for following up with insurance companies for unpaid claims
Responsible for communicating and resolving problems with the provider representatives when applicable
Payment posting corrections/adjustments and ability to distribute payments
Responsible for researching patient insurance coverage to identify and resubmit claims to fix coverage claim rejection/no pays
Client Accounts
Responsible for reviewing all accounts at the beginning of the month to make sure they are ready for statements. Work with clients on any billing questions they have Client refunds.
Job Requirements
Applicable Experience:
1 year