Billing/Recovery Specialist

At St. Luke's, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke's is truly a great place to work.

What You Can Expect:

The Billing Recovery Specialist is responsible for providing support in the functional areas of the Revenue Cycle, including Billing, Reimbursement, and Insurance Recovery. This role ensures adherence to company policies, procedures, and related government regulations.

PRIMARY RESPONSIBILITIES

Individual incumbents may be responsible for a general overview or may specialize in one or more of the functional areas of Revenue Cycle listed below:

Billing:

Prepares and submits claims to various insurance companies electronically or on paper. Verifies completeness and accuracy of all claims prior to submission, obtaining any missing information. Answers questions from patients, clerical staff, and insurance companies. Identifies and resolves billing complaints. Follows up on insurance claim denials, rejections, exceptions, or exclusions. Research missing registration and insurance information as needed. Prepares correspondence, denials, and resolutions as directed. Understands insurance plan coverages, authorizations, and limits.

Insurance Recovery:

Research trends and resolves claim rejections and denials. Collects and resolves delayed payments from insurance companies. Coordinates with departments and insurance companies to correct errors as necessary. Prepares correspondence, denial handling, and resolutions as directed. Responsible for analysis of denied reimbursement claims. Understands insurance plan coverages, authorizations, and limits.

Essential Functions:

Follows well-defined policies and procedures to perform assigned billing and recovery tasks. Solves problems of limited complexity and refers more complex issues to higher levels. Researches and resolves questions of limited complexity in nature. May serve as a resource to others in the resolution of problems and issues. Audits and proofs claims/reports for accuracy and conformance to departmental, government, and company regulations. Assists in special projects. Performs duties requiring independent thought and judgment. Performs other duties and responsibilities as assigned.

Qualifications:

Education:

High school diploma or equivalent

Experience:

1-year relevant experience