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ACCOUNTS RECEIVABLE SPECIALIST, HOSPITAL BILLING

St. Luke's University Health Network
Allentown, PA, United States
Full-time

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 day to day operations of accounts receivable for the facilities and practices including billing, account resolution, credits workflow and processes.

The Accounts Receivable Specialist II is focused on the accurate and timely submission of claims to third party payers, intermediaries, and guarantors in accordance with network policy.

Proactively reviews accounts with insurance payers to ensure prompt and maximum reimbursement.

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 Coordinator / Management team.
  • Uses insurance websites for claim status, appeals and corrections.
  • Obtains and maintains a basic understanding of third party billing requirements as assigned, including federal, state and commercial payers.
  • Responsible for accounts receivable and investigates and reviews number of claims set by productivity standards for the team.
  • Staff member productivity and accuracy is monitored on a regular basis.
  • Analyzes daily aging of high balance 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.
  • Refers accounts back to billing staff for any claims that need to be re-billed.

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. Must be able to speak, read and write English. Strong verbal and writing skills.

TRAINING AND EXPERIENCE :

Experience with third party billing in a hospital similar medical facility or physician's office is preferred. Must have two years experience at AR Specialist Level I within the network.

Direct experience is required in Microsoft Office Suite and web navigation and / or web based applications.

HOURS :

Mon-Fri, days, no nights, holidays, or weekends. Flexible start time after training. Remote / hybrid remote available after 6 months training at manager discretion.

Based at St. Luke's Center, Allentown, PA.

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. (http : / / www.slhn.org / EOE)

Founded in 1872, St. Luke's University Health Network (http : / / www.slhn.org / ) (SLUHN) is a fully integrated, regional, non-profit network of more than 20,000 employees providing services at 15 campuses and 300+ outpatient sites.

With annual net revenue of $3.5 billion, the Network's service area includes 11 counties in two states : Lehigh, Northampton, Berks, Bucks, Carbon, Montgomery, Monroe, Schuylkill and Luzerne counties in Pennsylvania and Warren and Hunterdon counties in New Jersey.

St. Luke's hospitals operate the largest network of trauma centers in Pennsylvania, with the Bethlehem Campus being home to St.

Luke's Children's Hospital.

SLUHN is the only Lehigh Valley-based health care system to earn Medicare's five-star ratings (the highest) for quality, efficiency and patient satisfaction.

It is both a Leapfrog Group and Healthgrades Top Hospital and a Newsweek World's Best Hospital. The Network's flagship University Hospital has earned the 100 Top Major Teaching Hospital designation from Fortune / Merative 11 times total and eight years in a row, including in 2023 when it was identified as THE #4 TEACHING HOSPITAL IN THE COUNTRY.

In 2021, St. Luke's was identified as one of the 15 Top Health Systems nationally.

SLUHN has been named a Top Workplaces 2023 by the Morning Call. In addition, St. Luke's has been named a Top Workplace nationally, in the Philadelphia region, and in New Jersey.

St. Luke's is the ONLY healthcare institution in Pennsylvania and the third-highest ranked healthcare entity in the nation to be deemed a Top Workplace in 2023.

In 2023, St. Luke's was named one of America's Best Employers for Women by Forbes. St. Luke's was the only employer in the Lehigh Valley to be named to the list and was one of only two healthcare employers in Pennsylvania to receive the designation.

St. Luke's University Health Network is the top-ranked Lehigh Valley-based employer in Forbes Magazine's ranking of employers in Pennsylvania.

Learn More Here. (http : / / www.slhn.org / About)

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