About

Imagine a career at one of the nation's most advanced health networks. Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work. LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day. Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network. Summary Maintains positive and productive relations with payor representatives an interdepartmental colleagues to facilitate and support the releasing of Par provider claims and expedites the claims denial investigation process, claim correction process, and resubmission to prevent a negative impact on revenue. Participates in operational group discussions on work flow improvements concerning, but not limited to, capturing provider movement, acquisitions, payer requirement enrollment updates, and Epic system related enrollment work. Job Duties Participates in the review of actions/alerts within the database with corresponding timelines to improve follow-up throughout the claims denial process to minimize delayed revenue and revenue loss. Maintains organized, complete, and updated files on all providers to illustrate current licenses, certifications, supervising/collaborative agreements, and correspondence via the scanning database. Monitors and investigates enrollment claim denials and directs billing resubmission to maximize revenue. Maintains necessary updates to spreadsheets utilized for tracking as it relates to new providers, new practices, and application status. Cultivates relationships with contract payer representatives to help anticipate changes in enrollment and re-enrollment to avoid claim denials. Recognizes opportunities for system set-up adds and modifications. Makes suggestions that will improve processes and communicates these opportunities to management. Minimum Qualifications High School Diploma/GED 5 years of experience working in billing, health insurance, physician practice, or similar environment and 5 years of previous experience in provider insurance with enrollment, denials, and follow-up. Effective prioritization of tasks to meet deadlines. Knowledge and thorough understanding of the revenue cycle process. Strong computer literacy skills. Preferred Qualifications Associate’s Degree Physical Demands Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR. Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require. Lehigh Valley Health Network is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. All personnel actions and programs will adhere to this policy. Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and/or social activities. https://youtu.be/GD67a9hIXUY Lehigh Valley Health Network does not accept unsolicited agency resumes. Agencies should not forward resumes to our job aliases, our employees or any other organization location. Lehigh Valley Health Network is not responsible for any agency fees related to unsolicited resumes. Work Shift: Day Shift Address: 1200 S Cedar Crest Blvd Primary Location: REMOTE IN PENNSYLVANIA Position Type: Remote Union: Not Applicable Work Schedule: Monday-Friday; 8:00a-4:30p Department: 1004-13054 CSS-Patient Accounting Lehigh Valley Health Network (LVHN) is the region’s largest employer and health care provider of choice. Our nearly 20,000 health care professionals take pride in what they do and are driven by our mission to heal, comfort and care for the people of our community. Submit your Resume to join our Talent Network and stay informed about future opportunities! LVHN is honored to be certified as a Great Place to Work®. LVHN’s culture of trust – and the positive things colleagues said about working at LVHN when surveyed by Great Place to Work and Fortune – align perfectly with what makes a great workplace. This designation tells you that LVHN is a great place to work from hire to retire. If you are someone who aligns with LVHN’s core values – Compassion, Integrity, Collaboration and Excellence – you will have a rewarding and successful career here.