Patient Accounts Representative

Saint Luke's Health System; Kansas City (MO); Hybrid; USD 42,000 - 62,000; Full time

Job summary

Saint Luke's Health System is seeking a Patient Accounts Representative to work from home in the Kansas City area. The role focuses on researching patient billing claims, correcting coding errors, and resubmitting claims to resolve coverage denials.

You will handle 277 EDI transactions, post payments, and coordinate with multiple teams to resolve complex issues. Applicants should have at least two years of experience in medical billing and hold a diploma.

Qualifications

• 2 years experience in medical billing or patient accounts.
• Diploma required.
• Candidates must reside in the Kansas City metropolitan area.

Responsibilities

• Research and correct patient billing claims for coding/claim errors.
• Identify and fix coverage denials with insurance payors.
• Prepare documentation for payors to process claims.
• Communicate with payors to resolve claim issues and denials.
• Process 277 EDI transactions and track rejections.
• Post payments and adjust charges as needed.
• Coordinate with teams to resolve patient billing concerns.

Skills

Healthcare billing

Claims research

EDI transactions

Billing software

Education

Diploma

Tools

EDI software

Billing software

Job description

## Patient Accounts RepresentativeApply: System Offices | 901 E 104 St | Kansas City | MO: Full time: Posted Today: JobReq0060509# **Job Description**Location: This position is a work from home positionSchedule: Flexible Schedule - Monday - Friday: 6:00AM - 6:00PMClaim 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**Candidate must live in or around the Kansas City metropolitan area.**# **Job Requirements**Applicable Experience:2 yearsDiploma# **Job Details**Full TimeDay (United States of America)