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.
Applicable Experience:
1 yearFull TimeDay (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.
About Saint Luke’s
Saint Luke’s serves the West Region of BJC Health System as a faith-based, nonprofit, aligned health system committed to providing the highest levels of excellence in compassionate health care and health-related services. Saint Luke’s cares for patients in 65 specialty services across 67 counties in Missouri and Kansas. Saint Luke’s Hospital has been recognized by U.S. News & World Report as one of the elite hospitals in the nation. For more than 140 years, Saint Luke’s has been dedicated to enhancing the physical, mental, and spiritual health of the diverse communities we serve.
Saint Luke’s offers:
- The region’s longest continuously operating adult heart transplant program and one of the nation’s leading cardiovascular programs at Saint Luke's Mid America Heart Institute
- Treatment for complex brain and spinal cord diseases and one of the nation’s leading stroke reversal programs at the nationally ranked Saint Luke’s Marion Bloch Neuroscience Institute
- The region’s only treatment center dedicated exclusively to treating metastatic breast cancer—the Koontz Center for Advanced Breast Cancer at Saint Luke’s Cancer Institute
- Saint Luke’s Convenient and Urgent Care clinics for treatment of minor illnesses and injuries
- Liver and kidney transplantation programs
- A comprehensive maternal-fetal diagnostic and treatment center
- Three Neonatal Intensive Care Units, including a Level IIIb NICU at Saint Luke’s Hospital of Kansas City
- Saint Luke’s Rehabilitation Institute, the only comprehensive inpatient rehabilitation hospital of its kind in the region
- A nationally recognized children's behavioral health center, Saint Luke’s Hospital Crittenton Children’s Center
