Patient Accounts Representative SLPG

Saint Luke's Health System; Kansas City (MO); Remote; USD 25,000 - 30,000; Full time

Job summary

Saint Luke’s Health System seeks a Patient Accounts Representative to manage billing, posting, and AR activities for hospital and physician billing.

You will resolve claim errors, handle denials and appeals, and coordinate with payors and providers. The role requires 1 year of applicable experience and offers a work-from-home setup for candidates in Kansas or Missouri.

Qualifications

• 1 year of applicable experience in patient billing or accounts receivable.
• Familiar with insurance claim processes and payer responsibilities.
• Ability to troubleshoot and respond to patient inquiries.

Responsibilities

• Research patient billing claims to correct errors and ensure proper processing.
• Handle denials and appeals with documentation and payer communication.
• Perform payment posting adjustments and monitor accounts receivable.
• Follow up with insurance companies for unpaid claims and respond to provider inquiries.
• Review accounts at month start and address client billing questions.

Skills

Billing

Claims research

Denials & appeals

Payment posting

Customer service

Communication

Tools

Billing software

Job description

Job Description Location: This position is a work from home position, candidate must be located in Kansas or Missouri Schedule: Flexible Schedule - Monday - Friday: 6:00AM - 6:00PM

Patient Accounts Representative is responsible for reviewing, billing, collection, and accounts receivable activities for the hospital (and in some cases the physician) billing departments within Saint Luke's Health System. Activities include, but are not limited to, entering demographics, troubleshooting issues, responding to inbound and outbound billing calls from patients, payment posting, resolving credits, identifying, and correcting medical claim errors that may prevent payment and identifying, correcting, and resubmitting medical claims denied by insurance companies. Resolving claim edits, working denials and appeals. Patient Account Representative may be responsible for any or all the following duties, including duties not otherwise assigned.

Claim Processing

• Responsible for researching patient billing claims to correct claim errors
• Understand respective payor requirements so claims are processed correctly
• Familiar with NCCI / NCD / LCD edits, incidentals/inclusive, and bundling rules, etc.
• Work with multiple teams/departments to resolve issues
• Hand billing of specialty care which may include residential care, transplant and research

Insurance Denials

• Responsible for researching, identifying errors, and correcting claims denied by insurance companies
• Responsible for writing appeal letters to insurance companies
• Research refund request from payor organizations
• Responsible for preliminary audit of billing code errors before claim resubmitted from denial
• Responsible for becoming a subject matter expert on the payor policies
• Payment posting corrections/adjustments and ability to distribute payments

Insurance Follow-Up

• Responsible for following up with insurance companies for unpaid claims
• Responsible for communicating and resolving problems with the provider representatives when applicable
• Payment posting corrections/adjustments and ability to distribute payments
• Responsible for researching patient insurance coverage to identify and resubmit claims to fix coverage claim rejection/no pays

Client Accounts

• Responsible for reviewing all accounts at the beginning of the month to make sure they are ready for statements
• Work with clients on any billing questions they have
• Client refunds

Job Requirements Applicable Experience: 1 year

Job Details PRN Day (United States of America)

Saint Luke’s Health System includes 18 hospitals and campuses across the Kansas City region, home care and hospice, behavioral health care, dozens of physician practices, a life care senior living community, and more. Find out more about what Saint Luke’s offers: http://www.saintlukeskc.org/about-saint-lukes

Saint Luke’s Health System values our employees and we encourage them to apply to any internal openings.