Patient Accounts Representative

Saint Luke's Health System•Kansas City, MO

1d•Remote

About The Position

This position is a work from home position with a flexible schedule, Monday through Friday, between 6:00 AM and 6:00 PM. The role involves researching patient billing claims and insurance coverage to identify and correct errors, resubmit claims, and ensure correct processing. Responsibilities include managing claim edits, handling insurance denials and follow-up, coordinating payment plans, and communicating with payors and internal teams. The candidate must reside in or around the Kansas City metropolitan area.

Requirements

Familiarity with NCCI edits, incidentals/inclusive, and bundling rules, etc.
2 years applicable experience
Diploma

Nice To Haves

Candidate must live in or around the Kansas City metropolitan area.

Responsibilities

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
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
Responsible for researching, identifying errors, and correcting claims denied by insurance companies.
Must be able to assess 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