Responsible for training and coordination of the activities related to third party claim form formats, claim “scrubbing,” claim submission and claims editing to ensure optimal reimbursement and maximization of cash flow, timely follow-up, denials resolution, payment posting and processing of all related correspondence. All of these functions will be worked in accordance with Federal and state requirements and all third party payers, as well as in accordance with physician and hospital policy and... more details
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.
Responsible for training and coordination of the activities related to third party claim form formats, claim “scrubbing,” claim submission and claims editing to ensure optimal reimbursement and maximization of cash flow, timely follow-up, denials resolution, payment posting and processing of all related correspondence. All of these functions will be worked in accordance with Federal and state requirements and all third party payers, as well as in accordance with physician and hospital policy and billing requirements/regulations.
ESSENTIAL FUNCTIONS:
- Provides guidance and/or assists AR specialists in third party claims submission process.
- Assists in the prioritization of work for the ongoing maintenance of the Epic system.
- Assists, when necessary, in the submission and follow-up of claims on a timely basis.
- Manages and/or maintains the necessary systems/equipment needed to accomplish the job duties of staff within the billing office.
- Handles and assists with training, productivity and refresher courses for assigned staff once initially trained.
- Identifies system or procedural problems creating third party claim rejections. Formulates and implements plans for minimizing or eliminating these rejections.
- Performs work as scheduled, prioritizing as required for maximum cash flow.
- Demonstrates thorough knowledge of third-party payers’ claims requirements, UB04 and 1500 requirements by payer, computer capabilities as related to claims production, and admitting/medical records input as they affect claims
- Comply with all hospital and departmental policies and procedures.
- Assists in formulating needed staff corrective action and initiates periodic staff evaluations.
- Functions as a back-up to members of the accounts receivable team within the Physician or Hospital Business Office.
PHYSICAL AND SENSORY REQUIREMENTS:
Sitting for up to eight hours per day, 4 hours at a time. Continuously fingering and handling for data entry, typing etc., and occasionally twisting and turning. Uses upper extremities for occasional lifting and carrying of up to 15lbs. Frequently stoops, bends, or reaches above should level to retrieves files. Hearing as it relates to normal conversation and telephone. Seeing, 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 / GED required.
TRAINING AND EXPERIENCE:
Three years of physician business office experience required.
Previous and thorough knowledge of third party payers and payment posting process for all major insurances required.
Previous experience and proficiency with Microsoft Office Suite preferred.
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 is an Equal Opportunity Employer.
