Job Description
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, weekends, or holidays
7:30 AM - 4:00 PM
Experience in hospital accounts receivable with government payors, such as Medicare and Medicaid, required.
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 backup 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 15 lbs. 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.
Numbers & Facts
| Location | Allentown, PA |
| Industry | Healthcare Services |
| Company Size | 5,000 to 9,999 employees |
About Company
St. Luke's University Health Network is a regional network of hospitals, physicians and other related organizations providing care primarily in Lehigh, Northampton, Monroe, Carbon, Schuylkill, Bucks, Montgomery and Berks counties in Pennsylvania and Warren County in New Jersey.
The Network provides services at more than 150 sites. St. Luke's University Health Network is comprised of six hospital sites. The Network includes:
- More than 80 owned physician-practice sites
- 300 employed primary care/specialist physicians
- Various outpatient testing and service facilities
- Home health
- Hospice services (inpatient and outpatient)
- Largest ambulance provider in Bucks County and second largest in Lehigh County
- Other related organizations
- 57,500+ annual admissions
- 195,000 annual emergency room visits
- 1,325 physicians on the Medical Staff (96 percent board-certified)
- 8,600+ employees
- More than 1,350 volunteers
Areas of exceptional medical expertise include:
- Level 1 Adult Trauma Center: fully accredited by Pennsylvania Trauma Systems Foundation; 2,400+ annual trauma cases; St. Luke's 1.75 percent mortality rate represents top decile performance, significantly better than peer group as measured by National Trauma Data Bank of the American College of Surgeons; aeromedical transport services
- Oncology: first and only cancer program in Pennsylvania to receive American College of Surgeons' highest quality recognition for three consecutive years; only Pennsylvania program to receive award in 2010; region's only fellowship-trained surgical oncologists; advanced programs for melanoma (internationally recognized melanoma investigator), lung, breast, prostate, gynecologic and gastrointestinal cancers and tumors of the brain and spine
- Cardiology and Cardiovascular Surgery: multiple-year recipient of highest rating for cardiac bypass surgery, represents top decile performance achieved by only 10 percent of U.S. hospitals (Society for Thoracic Surgery); region's first Joint Commission certified Heart Failure Program; comprehensive surgical services excluding heart transplants
- Neuroscience: accredited Stroke Center; additional Centers of Excellence include: Balance Center, Headache Center, Memory Disorders Center, Multiple Sclerosis Center, Sleep Disorders Center
- Orthopaedics: advanced expertise in total joint replacement and reconstruction, computer-assisted minimally invasive surgery, primary and reconstructive surgery of the spine, sports injuries, diseases and conditions of the hand and elbow, traumatic injuries
- Women's/Children's Health: high-risk pregnancy; the region’s busiest obstetrical service; two neonatal intensive care units; pediatric specialty care provided by St. Christopher's Hospital for Children.
- Robotic/Minimally Invasive Surgery: one of the nation's most experienced robotic surgical teams
- Radiology: designated international General Electric Healthcare Show Site for imaging technology; designated Breast Imaging Center of Excellence by American College of Radiology
- Bariatric Surgery: designated Center of Excellence by American Society for Metabolic and Bariatric Surgery and Surgical Review Corporation
St. Luke's offers an exceptional benefit plan for employees. Our values are reflected in all we do for patients, each other and the community:
Pride - We take pride in our accomplishments and in our organization.
Caring - We show consideration for others and their feelings. We treat others as we want to be treated.
Respect - We recognize the value, diversity and importance of each other, those we serve and the organization.
Accountability - We are responsible to make decisions and solve problems in a timely and effective manner.
Flexibility - We adapt to the changing needs and expectations of those we serve.
Teamwork - We work together to improve quality.
The mission of St. Luke's University Health Network 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.
Skills
- Accounts Receivableunmatched
- Billingunmatched
- Cash Flowunmatched
- Claims Processingunmatched
- Data Entryunmatched
- Editingunmatched
- Epic Systemsunmatched
- Establish Prioritiesunmatched
- Governmentunmatched
- Healthcareunmatched
- Healthcare Providersunmatched
- Hospitalunmatched
- Medicaidunmatched
- Medical Billingunmatched
- Medical Recordsunmatched
- Medicareunmatched
- Nursingunmatched
- Organizational Skillsunmatched
- Payment Postingunmatched
- Payment Processingunmatched
- People Managementunmatched
- Performance Reviewsunmatched
- Procedure Developmentunmatched
- Regulatory Requirementsunmatched
- Reimbursementunmatched
- Staff Corrective Actionunmatched
- Staff Trainingunmatched
- Systems Maintenanceunmatched
- Third-Party Payerunmatched
- Time Managementunmatched
- Typingunmatched
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