[Hiring] Patient Accounts Representative @Saint Luke's Health System

Role 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 Luke's 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
• Identifying, correcting, and resubmitting medical claims denied by insurance companies
• Resolving claim edits, working denials and appeals
• Evaluation and coding of ICD, CPT, HCPCS
• All coding initiatives, NCCI edits, incidentals/inclusive, and bundling rules
• Demonstrating competency for invalid diagnosis, modifiers, coding related issues

Preferred: Billing or Coding Certifications. Anesthesia billing experience is a must!

Qualifications

• 1 year of applicable experience
• Diploma

Requirements

• 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
• 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

Company Description