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LV
Lehigh Valley Health Network
Physician Biller
Career Insights for Claims Representative
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Based on Pennsylvania data
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What they do
A Claims Representative accepts and reviews applications for insurance and provides information to insurance agents. Assists insurance customers, answers questions and processes requests to change or cancel policies. May assist with insurance claims that are disputed, review claims and policy coverage and help to negotiate agreements between customers and an insurance company.
$57,306 / year median in Pennsylvania
+3% projected growth
Job Description
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
Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network.
SummaryUpdates patient information which usually consists of health care status, and health insurance. Works with the coding and credentialing departments to resolve issues or edits in an effort to avoid any delays in sending claims. Job DutiesAssists patients, families and insurance carriers with billing inquiries. Processes coding corrections and late charges. Works closely to identify inefficient claim edits and develops necessary and new claim edits. Reviews and resolves claims with missing information accounts (unchecked). Handles edits for patients registered as self-pay to ensure that there is not active Medicaid coverage. Follows up on denials and incorrectly paid claims, utilizing reports on daily, weekly and monthly basis. Reviews claims in pre-bill status for accuracy and coordinates with ancillary departments, as needed, to resolve claim edits. Documents billing activity on patient encounter according to departmental standards and guidelines. Minimum QualificationsHigh School Diploma/GED 1 year 1 year of experience in billing, or health insurance, within a physician's practice, or equivalent operations environment and Less than 1 year prior administrative experience. Excellent problem solving skills. Knowledge and thorough understanding of the revenue cycle process. Well developed oral/written communication skills. Strong orientation to patient/customer satisfaction. Preferred QualificationsAssociate's Degree Physical DemandsLift and carry 25 lbs. frequent sitting/standing, frequent keyboard use,
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.
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.
Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network.
SummaryUpdates patient information which usually consists of health care status, and health insurance. Works with the coding and credentialing departments to resolve issues or edits in an effort to avoid any delays in sending claims. Job DutiesAssists patients, families and insurance carriers with billing inquiries. Processes coding corrections and late charges. Works closely to identify inefficient claim edits and develops necessary and new claim edits. Reviews and resolves claims with missing information accounts (unchecked). Handles edits for patients registered as self-pay to ensure that there is not active Medicaid coverage. Follows up on denials and incorrectly paid claims, utilizing reports on daily, weekly and monthly basis. Reviews claims in pre-bill status for accuracy and coordinates with ancillary departments, as needed, to resolve claim edits. Documents billing activity on patient encounter according to departmental standards and guidelines. Minimum QualificationsHigh School Diploma/GED 1 year 1 year of experience in billing, or health insurance, within a physician's practice, or equivalent operations environment and Less than 1 year prior administrative experience. Excellent problem solving skills. Knowledge and thorough understanding of the revenue cycle process. Well developed oral/written communication skills. Strong orientation to patient/customer satisfaction. Preferred QualificationsAssociate's Degree Physical DemandsLift 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.