Schedule: Flexible Schedule - Monday - Friday: 6:00AM - 6:00PM

Claim Edits
* Responsible for researching patient billing claims to identify and correct coding/claim errors
* Responsible for researching patient insurance coverage to identify and resubmit claims to fix coverage denials.
* Research and outline documentation needed for respective payor organizations so that claims are processed correctly
* Familiarity with NCCI edits, incidentals/inclusive, and bundling rules, etc.
* Identify problem trends
* Communicate with payors for resolution to complications with claims
* Responsible for 277 EDI transactions/rejections
* Working with EDI transactions
* Payment posting corrections/adjustments and ability to distribute payments
* Correct/enter charges
* Work with multiple teams/departments to resolve issues
* Payment plan or financial assistance coordination

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

Why Saint Luke's?

We believe in creating a collaborative environment, while looking for innovative ways to improve. We offer competitive salaries and benefits packages to all eligible employees:

• Medical health plans

• Tuition reimbursement

• Leave of Absence, PTO, and various Welfare plans

• Retirement contributions

• Employee Assistance Program

Candidate must live in or around the Kansas City metropolitan area.