Patient Accounts Representative

Saint Luke's Health System•Kansas City, MO

About The Position

Saint Luke’s in Kansas City is seeking a Patient Accounts Representative to join our team. This role will give you the opportunity to perform billing claim edits and insurance follow up. Schedule: Flexible Schedule - Monday - Friday: 6:00AM - 6:00PM Claim Edits • 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, etc. • 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 Insurance Denials and Follow-Up • Responsible for researching, identifying errors, and correcting claims denied by insurance companies. • Must be able to asses 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 Why Saint Luke’s? We believe in creating a collaborative environment, while looking for innovative ways to improve. We offer competitive salaries and benefits packages to all eligible employees: Medical health plans Tuition reimbursement Leave of Absence, PTO, and various Welfare plans Retirement contributions Employee Assistance Program Candidate must live in or around the Kansas City metropolitan area. Job Requirements Applicable Experience: 1 year Diploma Job Details Full Time Day (United States of America) The best place to get care. The best place to give care. Saint Luke’s 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke’s means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter. Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer. Saint Luke’s Health System includes 18 hospitals and campuses across the Kansas City region, home care and hospice, behavioral health care, dozens of physician practices, a life care senior living community, and more. Find out more about what Saint Luke’s offers: http://www.saintlukeskc.org/about-saint-lukes Are you interested in staying up to date on openings at Saint Luke’s Health System? Simply sign up for job alerts at https://careers.saintlukeskc.org/job-alerts When we have opportunities that meet your interests, you will receive an email with the job details. Saint Luke’s Health System values our employees and we encourage them to apply to any internal openings. If you are a current Saint Luke's Health System employee, please apply through your Workday account by typing "Find Jobs" in the top left corner search bar. You can also follow the link below to the current internal career site to apply. http://www.myworkday.com/saintlukes/d/task/1422$1011.htmld

Requirements

Applicable Experience: 1 year
Candidate must live in or around the Kansas City metropolitan area.
Diploma

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
Familiarity with NCCI edits, incidentals/inclusive, and bundling rules, etc.
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 asses 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