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St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of …
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Allentown, Pennsylvania, United States · On-site
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Allentown, Pennsylvania, United States • Hybrid
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The specialist is responsible for the accurate submission and collection of medical claims for hospital and physician services. This includes analyzing aging reports, resolving denied claims, and ensuring maximum reimbursement from third-party payers.
A high school diploma is required, and a medical billing/coding certificate is preferred. Candidates should have experience with third-party billing and proficiency in Microsoft Office Suite.
Full Time, Days, 40 hours/week
Mon-Fri, no nights, holidays, or weekends
Flexible start time (after training)
Remote or hybrid remote possible after training on site, up to 6 months, for local (PA, NJ) candidate, at the manager's discretion.
The Accounts Receivable Specialist I is 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. The Accounts Receivable Specialist I is responsible for 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; performs all associated duties in order to ensure the completeness and accuracy of all claim information, facilitating maximum reimbursement.
Performs duties as scheduled, prioritizing as required to ensure claims are submitted timely, and maximize cash flow is received.
Verifies accuracy of billing data and makes revisions as need be.
Identifies and reports any claim submission issue trends to Management team.
Obtains and maintains a basic understanding of third party billing requirements as assigned, including federal, state and commercial payers.
Responsible for account receivable, investigates and reviews claims based on the productivity standards set by management.
Analyze daily aging of insurance accounts via the billing system to determine appropriate follow up for non- payment and delayed payment accounts, as well as to ensure compliance with all Federal, state, insurance payer and St. Luke’s Network policies.
Analyzes denied claims and investigates the reasons causing the denial and takes the necessary action to resolve the denial and/or resolution of the account.
Seeks resolution to problematic accounts and payment discrepancies with optimal goal of receiving accurate payments and maximum reimbursement.
Statuses claims resolution, appeals and corrected claims via payer websites when possible.
Sitting up to 8 hours per day, 4 hours at a time. Continuously fingering and handling for data entry, typing, etc… and occasional twisting and turning. Uses upper extremities for occasional lifting and carrying up to 10 lbs. Frequently stoops, bends, or reaches above shoulder level to retrieve files. Hearing as it relates to normal conversation and telephone. Seeing as it relates to general vision. Visual monotony when reading reports and reviewing computer screens.
High School Diploma or equivalent. Medical Billing/Coding Program certificate preferred. Must be able to speak, read and write English. Must possess strong verbal and written communication skills.
Experience with third party billing in a hospital similar medical facility or physician’s office is preferred. Direct experience is required with Microsoft Office Suite and web navigation and /or web based applications.
Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!
The care you trust. Now more than ever.
In 2025, the U.S. Department of Health and Human Services ranked St. Luke’s #1 – ahead of Houston Methodist and Mayo Clinic – as the nation’s top health system for quality, safety and patient experience. This objective recognition based on hospital data reported to the government reaffirms St. Luke’s preeminent position as a leader among the largest and most respected health care providers in the country. ✨
Offices: 801 Ostrum Street, Bethlehem, PA 18015, US · 1872 St Luke's Blvd, Easton, Pennsylvania 18045, US · 1021 Park Avenue, Quakertown, PA 18951, US · 1736 Hamilton Street, Allentown, PA 18103, US · 360 West Ruddle Street, Coaldale, PA 18218, US
