Patient Accounts Representative

Saint Luke's Health System•Kansas City, MO

10d•Remote

About The Position

The 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. This role involves entering demographics, troubleshooting issues, responding to inbound and outbound billing calls from patients, posting payments, resolving credits, identifying and correcting medical claim errors that may prevent payment, and identifying, correcting, and resubmitting medical claims denied by insurance companies. The representative will also be responsible for resolving claim edits and working denials and appeals. This position may be responsible for duties not otherwise assigned.

Requirements

1 year of applicable experience
Diploma

Responsibilities

Researching patient billing claims to correct claim errors.
Ensuring claims are processed correctly according to respective payor requirements.
Understanding NCCI / NCD / LCD edits, incidentals/inclusive, and bundling rules.
Collaborating with multiple teams/departments to resolve issues.
Handling billing for specialty care, including residential care, transplant, and research.
Researching, identifying errors, and correcting claims denied by insurance companies.
Writing appeal letters to insurance companies.
Researching refund requests from payor organizations.
Performing preliminary audits of billing code errors before claim resubmission.
Becoming a subject matter expert on payor policies.
Making payment posting corrections/adjustments and distributing payments.
Following up with insurance companies for unpaid claims.
Communicating and resolving problems with provider representatives when applicable.
Reviewing all accounts at the beginning of the month to ensure they are ready for statements.
Assisting clients with billing questions.
Processing client refunds.