St. Luke's University Health Network

Accounts Receivable

• 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.
• Accurate and timely submission of claims to third-party payers, intermediaries and guarantors in accordance with network policy.
• Process all UB04 and HCFA-1500 claims through the related billing system, working the related claims scrubber in a timely and efficient manner.
• Verify accuracy of billing data and make revisions as needed; identify and report claim submission issue trends to Management team.
• Investigate and review accounts receivable and claims based on productivity standards; analyze daily aging of insurance accounts to determine appropriate follow up for non-payment and delayed payment accounts.
• Analyze denied claims, investigate reasons for denial, take necessary action to resolve denials and/or resolve accounts; seek resolution to problematic accounts and payment discrepancies to receive accurate payments and maximum reimbursement.
• Status claims resolution, appeals and corrected claims via payer websites when possible.

Accounts Receivable Specialist, Physician Billing