Join a team that delivers excellence.

Lehigh Valley Health Network (LVHN) is home to nearly 23,000 colleagues who make up our talented, vibrant and diverse workforce.

Join our team and experience firsthand what it's like to be part of a health care organization that's nationally recognized, forward-thinking and offers plenty of opportunity to do great work.

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.

Participates in any or all aspects of the claim submission to third party carriers, incorporating industry best practices to ensure all state and federal billing guidelines and regulations are satisfied. Conducts root cause analysis of claim edits to determine corrective action to facilitate timely submission of claims and enhance the clean claim rate.

Job Duties

• Analyzes claim edits and conducts root cause analysis to resolve the edit, identifying opportunities for work flow process improvement and claim logic implementation to enhance the clean claim rate.
• Monitors claim rejections from insurance carriers, taking the corrective action necessary to resubmit the claim, escalating rejection trends to department leadership for the creation or modification of claim edits, claim rules, or for escalation to the provider rep.
• Maintains working knowledge of all regulatory claim form requirements, coding rules, LVHN protocols, as well as being proficient in all payer specific billing requirements.
• Participates in claim rebill projects to address updates to items such as payer contract modifications, CDM updates, correction to charge errors, and coding version changes.
• Maintains a positive and productive relationship with other LVHN Revenue Cycle Departments, instituting best practices to reinforce workflow standardization and optimize productivity.
• Processes late or corrected charges according to billing guidelines for payers, submitting late replacement claims, corrected claims, or processing late charge write-offs.
• Compiles documentation necessary for submission of paper claims: claim attachments, investigation of payer address, claim number; resolves eligibility situations, when necessary.

• High School Diploma/GED
• 2 years of professional or facility billing and/or collections for all major third party payers or work experience in healthcare related field.
• Knowledge of third party reimbursement.
• Knowledge of insurance contracts and regulations.
• Must maintain high-level knowledge of claim submission requirements.
• Strong analytical, mathematical, and organizational skills.
• Experience working with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).
• Successful completion of DOE and Revenue Cycle Education within 3 months of hire.

• Associate's Degree Healthcare Administration, Finance or Business or
• CPAT - Certified Patient Accounting Technician - State of Pennsylvania

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.

Influenza vaccination and COVID-19 Vaccination is required for all colleagues unless medically contraindicated or due to a bona fide religious belief or practice. Applicants possessing a medical marijuana card will not be considered for safety sensitive positions.

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

LVHN hospitals in the Lehigh Valley are the only hospitals in the region to have received Magnet recognition five consecutive times since 2002. This prestigious recognition from the American Nurses Credentialing Center demonstrates our commitment to nursing excellence and quality patient outcomes. LVHN is home to five clinical institutes. Each serve as a hub for innovation, collaboration and education. Our institutes include Lehigh Valley Topper Cancer Institute, Lehigh Valley Heart and Vascular Institute, Lehigh Valley Institute for Surgical Excellence, Lehigh Valley Fleming Neuroscience Institute and Lehigh Valley Orthopedic Institute. LVHN is also home to Lehigh Valley Reilly Children's Hospital, which is the only children's hospital in the region. This hospital gives our community access to more than 30 pediatric specialties, Children's ExpressCARE locations and a dedicated Children's ER.

We've been consistently recognized by U.S. News & World Report as the top hospital in the region and among the best in the state. We're also Great Place to Work-Certified, which means an overwhelming majority of our colleagues have a positive experience at LVHN.

These designations tell 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.

Individuals are required to adhere to all LVHN vaccination policies in effect at the time of hire. Employees will be subject to pre-employment drug and alcohol testing. Please note that safety sensitive positions cannot test positive for marijuana or its metabolites, medical or otherwise.

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.