Patient Accounts Representative

21 hours ago

Kansas City, MO, United States Saint Luke's Full time

Job Description​

Saint Luke’s in Kansas City is seeking a Patient Accounts Representative to join our team. This role will give you the opportunity to perform billing claim edits and insurance follow up.

Schedule: Flexible Schedule - Monday - Friday: 6:00AM - 6:00PM

Claim 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

Why Saint Luke’s?

We believe in creating a collaborative environment, while looking for innovative ways to improve. We offer competitive salaries and benefits packages to all eligible employees:

  • Medical health plans

  • Tuition reimbursement

  • Leave of Absence, PTO, and various Welfare plans

  • Retirement contributions

  • Employee Assistance Program

Candidate must live in or around the Kansas City metropolitan area.

Job Requirements

Applicable Experience:

1 year

Diploma

Job Details

Full Time

Day (United States of America)

The best place to get care. The best place to give care . Saint Luke’s 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke’s means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.

Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.

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