Schuylkill-posted 2 days ago
Full-time • Mid Level
Onsite • Allentown, PA
5,001-10,000 employees

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 Supports management in leading colleagues that are responsible for Account Receivable Follow up. Monitors work queues and identifies accounts that underpaid/unpaid or have line item denials for balance resolution. Works closely with the Supervisor/Manager to identify workflow or procedural processes to enhance collection of open Accounts Receivable. Monitors staff performance (e.g. productivity, quality) and meets regularly with colleagues to review results and to identify ways to improve performance in an effort to enhance revenue.

  • Leads team responsible for accurate and timely resolution of open Account Receivable.
  • Conducts quality reviews of accounts to ensure that accounts are being worked in a timely and efficient manner consistent with department standards.
  • Conducts desk side sessions with colleagues to review productivity, quality and address any questions/concerns as procedures are enhanced or new procedures developed.
  • Conducts initial training and education for colleagues, re-education sessions for existing colleagues, and remedial training as errors are identified.
  • Supports Supervisor/Manager in monitoring Epic Work Queues to ensure accounts are being worked based upon priority rating (from Priority 1 down).
  • Maintains up-to-date knowledge on payer requirements; recommends workflow changes as new requirements are implemented by the payer.
  • Serves as the Subject Matter Expert for colleagues to assist with claim payment or workflow procedure questions.
  • Reviews and approves adjustment and refund requests submitted by colleagues within established time parameters.
  • High School Diploma/GED
  • 3 years Professional and/or facility medical billing experience and/or medical accounts receivable experience utilizing automated patient accounting systems required for all major third party payers.
  • Proficiency in Microsoft Excel.
  • Working knowledge of Epic systems.
  • Strong analytical, mathematical, and problem-solving skills.
  • Knowledge of third party billing, claims processing procedures, and standard ANSI denial codes and remark codes.
  • Knowledge of Advance Beneficiary Notice of Medicare non-coverage services and the different types of ABNs or Waivers.
  • Knowledge of the use of modifiers needed for billing claims and reimbursement rules as they relate to all patient classes.
  • Knowledge of financial reporting systems, role of regulatory authorities, legal entities, and corporate governance.
  • Associate’s Degree
  • 5 years Professional and/or facility medical billing experience and/or medical accounts receivable experience utilizing automated patient accounting systems required for all major third party payers.
  • or 1 year Professional and/or hospital coding experience
  • CPB - Certified Professional Biller
  • AAPC - State of Pennsylvania within 180 Days
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