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Accounts Receivable Specialist I, St. Luke's Center (Full Time, First Shift)

Company: St. Luke's University Health Network
Location: Allentown
Posted on: January 12, 2021

Job Description:

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.Under the direction of the Business Office manager, this entry level position is responsible for the billing and collection of the accounts receivable for either St. Luke's Hospital services and/or the professional-fee billing for physician and advanced practitioner services for the St. Luke's Physician Group. The AR Specialist is primarily responsible for accurate and timely submission of claims to third-party payers, intermediaries and guarantors in accordance with network policy. They are responsible for the initial billing, rejection analysis and related claim resubmission, account resolution, credit workflow and all processes related to bringing the account balance to zero in a timely fashion. This position must work independently with a close level of supervision with the expectation that they will work with greater independence as they gain experience. Once determined through evaluations, productivity and accuracy that the AR Specialist has fulfilled their essential functions with quality and expertise, level II can be attained. JOB DUTIES & RESPONSIBILITIES:* Process all UB04 and HCFA-1500 claims through the related billing system, working the related claims scrubber0 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 Management team.* Obtains and maintains a basic understanding of third party billing requirements as assigned, including federal, state and commercial payers.* Responsible for account receivable, investigates and reviews claims based on the productivity standards set by management.* Analyze daily aging of 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.* Statuses claims resolution, appeals and corrected claims via payer websites when possible.* Handles phone, mail, and personal inquiries regarding patient accounts.* Initiates effective outbound calls and inbound calls to and from insurance companies to regarding claim status.* Communicates and corresponds with patients/guarantor and third party payers regarding Coordination of Benefits, Worker's compensation, and Auto insurance No-fault information.* Works collaboratively with departments and/or providers to obtain necessary information for follow -up (e.g., Medical Records, Contracting, Case Management, Patient Access, etc.)* Provides accurate, timely and relevant analysis on dispute and appeal letters after initial claim submission.* Documents all collection and follow up activities.* Responsible for following all collection policies and procedures. 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. Medical Billing/Coding Program certificate preferred. Must be able to speak, read and write English. Must possess strong verbal and written communication skills.TRAINING AND EXPERIENCE:Experience with third party billing in a hospital similar medical facility or physician's office is preferred. Direct experience is required:* Proficient in Microsoft Office Suite* Web navigation and /or web based applications.* Clerical experience* Ability to multi-task in a fast paced environment * Team Player* Demonstrate excellent customer service and communication skills, both written and verbal.* Applicant must be a highly motivated professional with organizational and analytical skill set, able to maintain confidentiality and evaluate multiple sides of an issue.* Applicant must possess a positive attitude.* Able to take the lead on projects and work well with minimal supervision. 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.

Keywords: St. Luke's University Health Network, Allentown , Accounts Receivable Specialist I, St. Luke's Center (Full Time, First Shift), Other , Allentown, Pennsylvania

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