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Accounts Receivable Specialist, Hospital Billing

1 month ago

Allentown, United States St. Luke's University Health Network Full time


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.

The Accounts Receivable Specialist I is responsible for the day to day operations of accounts receivable for the facilities and practices including billing, account resolution, credits workflow and processes. The Accounts Receivable Specialist II is focused on the accurate and timely submission of claims to third party payers, intermediaries, and guarantors in accordance with network policy. Proactively reviews accounts with insurance payers to ensure prompt and maximum reimbursement.

JOB DUTIES AND RESPONSIBILITIES:

  • Process all UB04 and HCFA-1500 claims through the related billing system, working the related claims scrubber in a timely and efficient manner; performs all associated duties in order to ensure the completeness and accuracy of all claim information, facilitating maximum reimbursement.
  • Performs duties as scheduled, prioritizing as required to ensure claims are submitted timely, and maximize cash flow is received.
  • Verifies accuracy of billing data and makes revisions as need be.
  • Identifies and reports any claim submission issue trends to Coordinator/Management team.
  • Uses insurance websites for claim status, appeals and corrections.
  • Obtains and maintains a basic understanding of third party billing requirements as assigned, including federal, state and commercial payers.
  • Responsible for accounts receivable and investigates and reviews number of claims set by productivity standards for the team.
  • Staff member productivity and accuracy is monitored on a regular basis.
  • Analyzes daily aging of high balance insurance accounts, via the billing system to determine appropriate follow up for non- payment and delayed payment accounts, as well as to ensure compliance with all Federal, state, insurance payer and St. Luke’s Network policies.
  • Analyzes denied claims and investigates the reasons causing the denial and takes the necessary action to resolve the denial and/or resolution of the account.
  • Seeks resolution to problematic accounts and payment discrepancies with optimal goal of receiving accurate payments and maximum reimbursement.
  • Refers accounts back to billing staff for any claims that need to be re-billed.

PHYSICAL AND SENSORY REQUIREMENTS:

Sitting up to 8 hours per day, 4 hours at a time.  Continuously fingering and handling 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.  Must be able to speak, read and write English.  Strong verbal and writing skills.

TRAINING AND EXPERIENCE:

Experience with third party billing in a hospital similar medical facility or physician’s office is preferred.  Must have two years experience at AR Specialist Level I within the network.  Direct experience is required in Microsoft Office Suite and web navigation and /or web based applications.

HOURS:

Mon-Fri, days, no nights, holidays, or weekends. Flexible start time after training. Remote/ hybrid remote available after 6 months training at manager discretion. Based at St. Luke's Center, Allentown, PA.

Please complete your application using your full legal name and current home address.  Be sure to include employment history for the past seven (7) years, including your present employer.  Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable.  It is highly recommended that you create a profile at the conclusion of submitting your first application.  Thank you for your interest in St. Luke's



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