Billing/Recovery Specialist

				Overview:

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.

Must be located in Idaho, Oregon, Utah or Arizona!

What you can expect from this role:

The Billing/Recovery Specialist is responsible for providing support in the functional areas of Revenue Cycle which includes Billing, Reimbursement & Insurance Recovery. Ensures adherence to company policies, procedures, and related government regulations.

* Prepares and submits claims to various insurance companies either electronically or by paper.
* Verifies completeness and accuracy of all claims prior to submission. Obtains any missing information.
* Answers questions from patients, clerical staff and insurance companies.
* Identifies and resolves billing complaints.
* May follow-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.
* Researches, 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.
* Under limited supervision, follows well-defined policies and procedures. Provides support to more experienced personnel by performing routine assignments, moderately difficult in nature, requiring a broad knowledge of theory and principles.
* 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.
* May audit and proof claim/reports for accuracy and conformance to departmental, government and company regulations.
* May assist 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: 2 year's experience.

Responsibilities:

The Billing/Recovery Specialist 2 is responsible for providing support in the functional areas of Revenue Cycle which includes Billing, Reimbursement & Insurance Recovery. 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:
The Billing Specialist 2 is responsible for collecting, posting and managing patient account data. . Responsible for submitting claims and following up with insurance companies.

*  Prepares and submits claims to various insurance companies either electronically or by paper.

*  Verifies completeness and accuracy of all claims prior to submission. Obtains any missing information.

*  Answers questions from patients, clerical staff and insurance companies.

*  Identifies and resolves billing complaints.

*  May follow-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:
The Insurance Recovery Specialist 2 is responsible for the collection of payments from insurance companies.

*  Researches, 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.

* Under limited supervision, follows well-defined policies and procedures. Provides support to more experienced personnel by performing routine assignments, moderately difficult in nature, requiring a broad knowledge of theory and principles. 

* 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. 

* May audit and proof claim/reports for accuracy and conformance to departmental, government and company regulations. 

* May assist 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: 2 year's experience.
* Licenses/Certifications: None
			

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