The Patient Account Representative is responsible for reviewing and auditing billing charges, collections, straightforward coding, and accounts receivable activities for physician clinics within Saint Luke's Health System.
Responsibilities include entering charge demographics, troubleshooting charge-related issues raised by clinic staff, responding to inbound and outbound billing calls from patients, posting payments, resolving payment credits, identifying and correcting medical claim errors, and resubmitting claims denied by insurance companies.
The role also involves resolving claim edits, managing denials and appeals, evaluating ICD, CPT, and HCPCS coding, and working with NCCI edits, incidental/inclusive rules, bundling rules, invalid diagnosis codes, modifiers, and other coding-related issues.
Key areas of focus include claim edits, insurance denials and follow-up, payment posting corrections, payment distribution, charge entry, escalation of complex denials, and coordination with multiple teams to resolve billing and coding issues.
Applicants should have at least 1 year of applicable experience.
Preferred qualifications include billing or coding certifications.
Experience or familiarity with:
- Researching and correcting coding and claim errors
- Insurance coverage research and claim resubmission
- NCCI edits, incidental/inclusive rules, and bundling rules
- 277 EDI transactions and rejections
- Payment posting corrections and adjustments
- Writing appeal letters and following up on denied or unanswered claims
- Diagnosis review, modifier application, and simple CPT code changes
- Communicating with payors and provider representatives
- Identifying trends and escalating complex billing issues when needed
Location
Kansas City, Missouri, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
3 weeks ago