Accounts Receivable Specialist- Variance

St. Luke's University Health Network

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.

Hours:

Full Time, Days, 40 hours/week.

Mon-Fri

No nights, holidays, or weekends

Flexible start times available: 7:00-3:30, 7:30-4:00, 8:00-4:30, or 8:30-5:00

Home location of St. Luke's Center, Allentown, PA

Remote or hybrid remote opportunity available, after training, meeting productivity goals, and at the discretion of the manager's approval for local (PA, NJ) candidates.

This role is for hospital variance reviews.

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.
• Analyzes 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.

St. Luke's University Health Network is an Equal Opportunity Employer.

St. Lukes University Health Network