Accounts Receivable Specialist-Physician Billing

St. Luke’s University Health Network; Allentown (Lehigh County); On-site; USD 42,000 - 54,000; Full time

Job summary

St. Luke's University Health Network in Allentown, PA seeks an Accounts Receivable Specialist I to manage billing and collections for hospital and physician services.

You will process UB04 and HCFA-1500 claims, verify data accuracy, follow up on aging accounts, analyze denials, and work with management to maximize reimbursement and cash flow.

The role emphasizes attention to detail, strong communication, and proficiency with Microsoft Office and billing systems.

Qualifications

• High School Diploma or equivalent.
• Medical Billing/Coding Program certificate preferred.

Responsibilities

• Process UB04 and HCFA-1500 claims in the billing system to ensure accurate submission.
• Verify billing data accuracy and revise as needed.
• Follow up on aging to maximize reimbursement and cash flow.
• Analyze denied claims and resolve issues with accurate resolutions.
• Escalate and report recurring submission issues to Management.

Skills

Attention to detail

Verbal communication

Written communication

Education

High School Diploma

Medical Billing/Coding Program certificate

Tools

Microsoft Office Suite

Web navigation / web-based applications

Job description

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.HOURS :Full time, Days, 40 hours/weekThe Accounts Receivable Specialist I is responsible for the billing and collection of the accounts receivable for either St. Luke’s Hospital services and/or the professional-fee billing for physician and advanced practitioner services for the St. Luke’s Physician Group. The Accounts Receivable Specialist I is responsible for accurate and timely submission of claims to third-party payers, intermediaries and guarantors in accordance with network policy.JOB DUTIES AND 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.PHYSICAL AND SENSORY REQUIREMENTS:Sitting up to 8 hours per day, 4 hours at a time. Continuously fingering and handling for data entry, typing, etc… and occasional twisting and turning. Uses upper extremities for occasional lifting and carrying up to 10 lbs. Frequently stoops, bends, or reaches above shoulder level to retrieve files. Hearing as it relates to normal conversation and telephone. Seeing as it relates to general vision. Visual monotony when reading reports and reviewing computer screens.EDUCATION:High School Diploma or equivalent. Medical Billing/Coding Program certificate preferred. Must be able to speak, read and write English. Must possess strong verbal and written communication skills.TRAINING AND EXPERIENCE:Experience with third party billing in a hospital similar medical facility or physician’s office is preferred. Direct experience is required with Microsoft Office Suite and web navigation and /or web based applications.Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!St. Luke's University Health Network is an Equal Opportunity Employer.