Patient Accounts Representative

Saint Lukes; Kansas City (MO); Remote; USD 40,000 - 60,000; Full time

Job summary

Ein etabliertes Gesundheitsunternehmen sucht einen Patient Account Representative, der für die Überprüfung und Korrektur von Abrechnungen sowie die Bearbeitung von Versicherungsansprüchen verantwortlich ist. In dieser Rolle arbeiten Sie eng mit verschiedenen Teams zusammen, um sicherzustellen, dass alle Ansprüche korrekt eingereicht und bearbeitet werden. Das Unternehmen bietet eine innovative und kollaborative Arbeitsumgebung, in der Ihre Fähigkeiten geschätzt werden. Wenn Sie eine Leidenschaft für den Kundenservice und die Gesundheitsversorgung haben, ist dies die perfekte Gelegenheit für Sie.

Benefits

Medizinische Gesundheitspläne

Studiengebührenrückerstattung

Bezahlte Freizeit

Rentenbeiträge

Mitarbeiterhilfeprogramm

Qualifications

• Ausgezeichnete Kundenservicefähigkeiten und starke Computerkenntnisse sind erforderlich.
• Mindestens 1 Jahr einschlägige Erfahrung ist wünschenswert.

Responsibilities

• Überprüfung und Korrektur von Abrechnungsfehlern und Ansprüchen.
• Bearbeitung von Versicherungsablehnungen und Nachverfolgung von Ansprüchen.
• Kommunikation mit Versicherungsvertretern zur Problemlösung.

Skills

Kundenservice

Computerkenntnisse

Kritisches Denken

Multitasking

Education

1 Jahr relevante Erfahrung

Job description

Job Description

The Patient Account Representative will be responsible for reviewing and auditing billing charges, billing, collection, straightforward coding, and all account receivable activities for the physician clinics within Saint Luke's Health System. Activities include, but are not limited to, entering charge demographics, troubleshooting charge-related issues raised by clinic staff, responding to inbound and outbound billing calls from patients, payment posting, resolving payment credits, identifying and correcting medical claim errors that may prevent payment, and identifying, correcting, and resubmitting medical claims denied by insurance companies. The role also involves resolving claim edits, working denials and appeals.

Shift Details

Monday - Friday, Full Time Day

Location

The candidate must reside in the Kansas City Metro area. This position is work from home.

Responsibilities

• Claim Edits
• Researching patient billing claims to identify and correct coding/claim errors.
• Researching patient insurance coverage to identify and resubmit claims to fix coverage denials.
• Outlining documentation needed for payor organizations to ensure correct claim processing.
• Familiarity with NCCI edits, incidentals/inclusive, and bundling rules.
• Identifying problem trends and communicating with payors for resolution.
• Managing 277 EDI transactions/rejections and working with EDI transactions.
• Performing payment posting corrections/adjustments and distributing payments.
• Correcting/entering charges and working with multiple teams to resolve issues.
• Coordinating payment plans or financial assistance.

• Insurance Denials and Follow-Up
• Researching, identifying errors, and correcting claims denied by insurance companies.
• Assessing claims to determine appropriate actions such as charge adjustments, voiding charges, or escalating.
• Writing appeal letters and following up on no-response claims.
• Handling escalated patient calls regarding billing code issues.
• Researching refund requests from payor organizations.
• Performing preliminary audits of billing code errors before submitting to the Coding team.
• Routing complex claim denials to the appropriate team.
• Identifying issues that can be resolved through programming software to prevent denials.
• Becoming a subject matter expert on payor policies.
• Communicating and resolving issues with provider representatives.
• Performing simple level coding, including diagnosis review, modifier applications, and some CPT code changes following process documents and payor policies.

Qualifications

Excellent customer service skills, strong computer and critical thinking skills, and the ability to multitask are essential. The ideal candidate has at least 1 year of applicable experience.

Why Saint Luke's?

We believe in creating a collaborative environment and continually seeking innovative improvements. We offer competitive salaries and benefits, including:

• Medical health plans
• Tuition reimbursement
• Paid time off
• Retirement contributions
• Employee Assistance Program

Additional Information

Saint Luke's is the best place to get and give care. Our 12,000 employees strive toward this vision daily. As the only faith-based, nonprofit, locally owned health system in Kansas City, we are proud to be a diverse and inclusive workplace where all voices matter. Join us as we serve the Kansas City region and provide exceptional health services. We are an Equal Opportunity Employer.