Patient Account Representative (Anesthesia Claims)

Job Description​

The Patient Account Representative will be responsible for billing, collection, straightforward coding, and all account receivable activities for the physician clinics within Saint Luke’s Health System.  Activities include, but are not limited to, responding to inbound and outbound billing calls from patients, payment posting, resolving payment credits, identifying and correcting medical claim errors that may prevent payment and identifying, correcting, and resubmitting medical claims denied by insurance companies. 

Percentage of time spent on job duties above will vary dependent on the focus area of team assigned.  A summary of specific team duties are described below, all to include other duties as assigned.  

Anesthesia Insurance Denials and Follow-Up
• Responsible for researching, identifying errors, and correcting claims denied by insurance companies.
• Must be able to assess 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

****Candidates for this position must have a strong background in working Anesthesia outstanding A/R, denials, and appeals****

This position has flex hours, employee works 5 days a week Monday -Friday.  Employee can choose how to work 8 hour days anytime between 6:00am-5:30 pm (with a start time no later than 9am).  Position also has the ability to telecommute, offers career ladder advancement opportunities, and includes a bonus program.

Education

Diploma

Certifications

Work Shift

Day (United States of America)

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Saint Luke's Health System