Patient Accounts Representative SLPG

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:

Job Details