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:
Candidate must live in or around the Kansas City metropolitan area.
Applicable Experience:
1 year
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.
J oin the Kansas City region's premiere provider of health services. Equal Opportunity Employer.
