Accounts Receivable Specialist- Physician Billing

St. Luke's University Health Network•Allentown, PA

About The Position

St. Luke's University Health Network is a fully integrated, regional, non-profit network of over 23,000 employees dedicated to excellence in patient care, education for healthcare providers, and improving access to care. The network operates 16 campuses and 350+ outpatient sites across 11 counties in Pennsylvania and New Jersey, with annual net revenue exceeding $4 billion. St. Luke's is recognized for quality, efficiency, and patient satisfaction, earning Medicare’s five-star ratings, being a Leapfrog Group and Healthgrades Top Hospital, and a Newsweek World’s Best Hospital. Its flagship University Hospital has been a Premier 100 Top Major Teaching Hospital multiple times and was identified as the #4 Teaching Hospital in the country in 2023. St. Luke's has also been recognized as a national Top Workplace by USA Today for three consecutive years. The Accounts Receivable Specialist I is responsible for the billing and collection of accounts receivable for St. Luke’s Hospital services and/or professional-fee billing for physician and advanced practitioner services for the St. Luke’s Physician Group. This role ensures accurate and timely submission of claims to third-party payers, intermediaries, and guarantors in accordance with network policy.

Requirements

High School Diploma or equivalent.
Ability to speak, read and write English.
Strong verbal and written communication skills.
Direct experience with Microsoft Office Suite and web navigation and /or web based applications.

Nice To Haves

Medical Billing/Coding Program certificate.
Experience with third party billing in a hospital similar medical facility or physician’s office.

Responsibilities

Process all UB04 and HCFA-1500 claims through the related billing system, working the related claims scrubber in a timely and efficient manner; performs all associated duties in order to ensure the completeness and accuracy of all claim information, facilitating maximum reimbursement.
Performs duties as scheduled, prioritizing as required to ensure claims are submitted timely, and maximize cash flow is received.
Verifies accuracy of billing data and makes revisions as need be.
Identifies and reports any claim submission issue trends to Management team.
Obtains and maintains a basic understanding of third party billing requirements as assigned, including federal, state and commercial payers.
Responsible for account receivable, investigates and reviews claims based on the productivity standards set by management.
Analyze daily aging of insurance accounts via the billing system to determine appropriate follow up for non- payment and delayed payment accounts, as well as to ensure compliance with all Federal, state, insurance payer and St. Luke’s Network policies.
Analyzes denied claims and investigates the reasons causing the denial and takes the necessary action to resolve the denial and/or resolution of the account.
Seeks resolution to problematic accounts and payment discrepancies with optimal goal of receiving accurate payments and maximum reimbursement.
Statuses claims resolution, appeals and corrected claims via payer websites when possible.