Accounts Receivable Specialist - Hospital Billing

St. Luke's University Health Network - Allentown, PA

Full-time - Entry Level

Hybrid - Allentown, PA

Hospitals

About the position

The Accounts Receivable Specialist II at St. Luke's is responsible for managing the day-to-day operations of accounts receivable, focusing on the accurate and timely submission of claims to third-party payers. This role involves ensuring maximum reimbursement through proactive account reviews and resolving any issues related to claim submissions.

Responsibilities

• Process all UB04 and HCFA-1500 claims through the related billing system.
• Perform all associated duties to ensure completeness and accuracy of claim information.
• Prioritize tasks to ensure timely submission of claims and maximize cash flow.
• Verify accuracy of billing data and make necessary revisions.
• Identify and report any claim submission issue trends to the Coordinator/Management team.
• Use insurance websites for claim status, appeals, and corrections.
• Maintain understanding of third-party billing requirements for federal, state, and commercial payers.
• Investigate and review claims set by productivity standards for the team.
• Analyze daily aging of high balance insurance accounts for follow-up on non-payment and delayed payment accounts.
• Analyze denied claims, investigate reasons for denial, and take necessary actions for resolution.
• Refer accounts back to billing staff for any claims that need to be re-billed.

Requirements

• High School Diploma or equivalent.
• Strong verbal and writing skills in English.
• Experience with third-party billing in a hospital or similar medical facility is preferred.
• Two years of experience at AR Specialist Level I within the network is required.
• Direct experience in Microsoft Office Suite and web navigation/web-based applications.

Nice-to-haves

• Experience in a medical billing environment.
• Familiarity with insurance websites and claim processing.

Benefits

• Remote/hybrid work options available after 6 months of training at manager's discretion.