Billing/Recovery Specialist

St. Luke's Health System•Boise, ID

26d

About The Position

At St. Luke’s, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke’s is truly a great place to work. What You Can Expect: The Billing/Recovery Specialist is responsible for providing support in the functional areas of Revenue Cycle which includes Billing, Reimbursement and Insurance Recovery. Ensures adherence to company policies, procedures, and related government regulations. PRIMARY RESPONSIBILITIES: Individual incumbents may be responsible for a general overview or may specialize in one or more of the functional areas of Revenue Cycle listed below: Billing: The Billing Specialist is responsible for collecting, posting and managing patient account data. Responsible for submitting claims and following up with insurance companies. Prepares and submits claims to various insurance companies either electronically or by paper. Verifies completeness and accuracy of all claims prior to submission. Obtains any missing information. Identifies and resolves billing complaints. May follow-up on insurance claim denials, rejections, exceptions or exclusions. Prepares correspondence and resolutions as directed. Understands insurance plan coverages, authorizations and limits. Insurance Recovery: The Insurance Recovery Specialist 1 is responsible for the collection of payments from insurance companies. Research, trend and resolve claim rejections and denials. Collects and resolves delayed payments from insurance companies. Coordinates with departments and insurance companies to correct errors as necessary. Prepares correspondence, denial handling and resolutions as directed. Responsible for analysis of denied reimbursement claims. Understands insurance plan coverages, authorizations and limits. Under direct supervision, performs basic, routine duties of limited scope and complexity. Performs standardized and routine tasks. Resolves routine questions and problems and refers more complex issues to higher levels. May audit and proof claim/reports for accuracy and conformance to departmental, government and company regulations. May assist in special projects. Performs other duties and responsibilities as assigned.

Requirements

High School Diploma or equivalent.
1 year experience

Responsibilities

Collecting, posting and managing patient account data.
Submitting claims and following up with insurance companies.
Preparing and submitting claims to various insurance companies either electronically or by paper.
Verifying completeness and accuracy of all claims prior to submission.
Obtaining any missing information.
Identifying and resolving billing complaints.
Following-up on insurance claim denials, rejections, exceptions or exclusions.
Preparing correspondence and resolutions as directed.
Understanding insurance plan coverages, authorizations and limits.
Researching, trending and resolving claim rejections and denials.
Collecting and resolving delayed payments from insurance companies.
Coordinating with departments and insurance companies to correct errors as necessary.
Responsible for analysis of denied reimbursement claims.
Auditing and proofing claim/reports for accuracy and conformance to departmental, government and company regulations.
Assisting in special projects.
Performing other duties and responsibilities as assigned.