St. Luke's
Healthcare
AccountsReceivableSpecialist
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Accounts Receivable Specialist at St. Luke's. Skills: billing, claims processing, accounts receivable management. billing and collection of accounts receivable. accurate and timely submission of claims to third-party payers”
What You'll Achieve.
maximum reimbursement; maximize cash flow; accurate payments
Industry & Context.
investigates and reviews claims; analyzes denied claims; investigates the reasons causing the denial; takes the necessary action to resolve the denial; Seeks resolution to problematic accounts and payment discrepancies
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
What They're Looking For.
Must Have
Must be able to speak, read and write English, Direct experience is required with Microsoft Office Suite and web navigation and /or web based applications
Nice to Have
Medical Billing/Coding Program certificate preferred, Experience with third party billing in a hospital similar medical facility or physician’s office is preferred
What You'll Do.
billing and collection of accounts receivable
accurate and timely submission of claims to third-party payers
processing UB04 and HCFA-1500 claims
working the related claims scrubber
ensuring completeness and accuracy of all claim information
maximizing reimbursement
prioritizing tasks to ensure timely claims submission and maximize cash flow
verifying accuracy of billing data
identifying and reporting claim submission issue trends
investigating and reviewing claims
analyzing daily aging of insurance accounts
analyzing denied claims and investigating reasons for denial
resolving problematic accounts and payment discrepancies
statusing claims resolution
appeals and corrected claims
How You'll Work.
Communication Scope
verbal communication skills; written communication skills
Full 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._ The Accounts Receivable Specialist I 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 Accounts Receivable Specialist I is responsible for accurate and timely submission of claims to third-party payers, intermediaries and guarantors in accordance with network policy. **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 ens
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