St. Luke's University Health Network
St. Luke's University Health Network
Posted 3 months ago
Full Time
Allentown, Pennsylvania
In Person
Smart Summary
Responsibilities
Responsible for the accurate submission of hospital and professional-fee claims to third-party payers and guarantors. The role involves analyzing aging reports, resolving denied claims, and ensuring maximum reimbursement through timely follow-up.
Qualifications
You have a High School Diploma or equivalent and possess strong verbal and written communication skills. You are proficient with Microsoft Office Suite, web navigation, and web-based applications, and have experience with third-party billing in a hospital or medical facility setting.
Must Have Skills for ATS
UB04
HCFA-1500
Microsoft Office Suite
Medical Billing
Medical Coding
Job Description
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 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.
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 with Microsoft Office Suite and web navigation and /or web based applications.
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
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