Patient Accounts Representative

Saint Luke's Health System; United States; Remote; USD 40,000 - 70,000; Full time

Job summary

An established industry player is seeking a Patient Account Representative to join their dedicated team. This role involves reviewing and auditing billing charges, managing insurance claims, and providing excellent customer service. The ideal candidate will possess strong analytical skills and the ability to multitask effectively in a dynamic environment. The company values collaboration and innovation, offering competitive salaries and a range of benefits, including health plans and tuition reimbursement. If you're looking to make a meaningful impact in patient care, this opportunity is perfect for you.

Benefits

Medical Health Plans

Tuition Reimbursement

Paid Time Off

Retirement Contributions

Employee Assistance Program

Qualifications

• 1 year of applicable experience in billing or account management.
• Strong understanding of medical billing processes and insurance claims.

Responsibilities

• Review and audit billing charges and collection activities.
• Research and correct billing claim errors and denials.
• Manage appeals and communicate with payors for claim resolution.

Skills

Customer Service Skills

Critical Thinking

Multitasking

Computer Skills

Education

High School Diploma

Associate's Degree

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 managing appeals.

Shift Details

Monday - Friday, Full Time, Day shift

Location

Candidate must reside in the Kansas City Metro area. This position is remote (work from home).

Responsibilities

• Claim Edits
• Research patient billing claims to identify and correct coding/claim errors
• Research patient insurance coverage to identify and resubmit claims to fix coverage denials
• Outline documentation needed for payor organizations to ensure correct processing
• Familiarity with NCCI edits, incidentals/inclusive, bundling rules, etc.
• Identify problem trends
• Communicate with payors for claim resolution
• Manage 277 EDI transactions and rejections
• Work with EDI transactions
• Perform payment posting corrections and adjustments
• Correct and enter charges
• Collaborate with multiple teams to resolve issues
• Coordinate payment plans or financial assistance
• Insurance Denials and Follow-Up
• Research, identify errors, and correct denied claims
• Assess claims to determine appropriate charge adjustments, voids, or escalation
• Write appeal letters to insurance companies
• Follow up on unresponded claims
• Handle escalated patient calls regarding billing code issues
• Research refund requests from payors
• Preliminary audit of billing code errors before submission to Coding team
• Route complex claim denials to team lead or appropriate team
• Identify issues that can be resolved through programming software
• Become a subject matter expert on payor policies
• Communicate and resolve issues with provider representatives
• Perform simple coding tasks, including diagnosis review, modifier application, and CPT code adjustments following policies

We seek candidates with excellent customer service skills, strong computer skills, critical thinking, and the ability to multitask.

Why Saint Luke’s?

We foster a collaborative environment and seek innovative improvements. We offer competitive salaries and benefits, including:

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

Job Requirements

Applicable experience: 1 year

Job Details

Full Time, Day shift, United States of America

Saint Luke’s is committed to excellence in patient care. Join our diverse and inclusive team of professionals striving to make a difference. We are an equal opportunity employer.