Medical Billing Representative - Hospital Billing

St. Luke's University Health Network; United States; Hybrid; USD 38,000 - 54,000; Full time

Job summary

St. Luke's University Health Network is seeking a full-time Medical Billing Specialist based at its Allentown, PA Center. The role runs Monday–Friday, 7:30 AM–4:00 PM, with some hybrid remote flexibility after six months, depending on local management.

You will process UB04 and HCFA-1500 claims, ensure data accuracy and maximize reimbursement. The ideal candidate has a high school diploma (Medical Billing/Coding preferred), strong organizational and computer skills, and experience with

Qualifications

• High School Diploma or equivalent; Medical Billing/Coding program preferred.
• Must speak, read and write English; strong verbal and written communication skills.
• Experience with third-party billing in a hospital or physician's office; EPIC experience a plus.

Responsibilities

• Process all UB04 and HCFA-1500 claims through the billing system to maximize reimbursement.
• Submit claims timely to ensure maximum cash flow.
• Verify accuracy of billing data and make revisions as needed.
• Identify and report claim submission trends to management.
• Coordinate with patients, guarantors and third-party payers on COB, Worker's comp and auto no-fault information.

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/ week Mon-Fri, no nights, holidays, or weekends 7:30 AM - 4:00 PM, some flexibility

Based at St. Luke's Center in Allentown PA. Hybrid remote opportunity available for local (PA, NJ) candidates, after 6 months on site training and at the manager's discretion.

JOB DUTIES AND RESPONSIBILITES:

• Process all UB04 and HCFA-1500 claims through the related billing system, working the related claims scrubber in a timely and efficient manner, performing all associated duties to ensure the completeness and accuracy of all claim information, facilitating maximum reimbursement.
• Perform duties as scheduled, prioritizing as required to ensure claims are submitted timely, and maximum cash flow is received.
• Verifies accuracy of billing data and makes revisions as needed.
• Identify and report any claim submission issue trends to Management team.
• Obtains and maintains an understanding of third-party billing requirements as assigned, including federal, state, and commercial payors.
• Responsible for accounts receivable, investigates and reviews claims based on the productivity standards set by management.
• Communicates and corresponds with patients/guarantors and third-party payers regarding Coordination of Benefits, Worker's compensation, and Auto insurance No-fault information.

PHYSICAL AND SENSORY REQUIREMENTS:

Sitting up to 8 hours per day, 4 hours at a time. Continuously handling paperwork 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 is preferred. Must be able to speak, read and write English. Strong organizational and computer skills is preferred. Must possess strong verbal and written communication skills. Additional educational degrees that relate to this position would be considered.

TRAINING AND EXPERIENCE:

Experience with third party billing in a hospital similar medical facility or physician's office is required. Direct experience is preferred. Proficient in Microsoft Office Suite. Web navigation and /or web-based applications. Clerical experience. Ability to multi-task in a fast-paced environment. Team Player. Demonstrate excellent customer service and communication skills, both written and verbal. Applicants must be a highly motivated professional with organizational and analytical skill set, able to maintain confidentiality and evaluate multiple sides of an issue. Applicants must possess a positive attitude. Able to take the lead on projects and work well with minimal supervision. EPIC computer system experience a plus

St. Luke's University Health Network is an Equal Opportunity Employer.