Insurance Follow-Up Representative

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🔥 17 horas atrás

🔔 Pennsylvania – Remoto

🔔 Pennsylvania – Remote

⏰ Tempo Integral

🟢 Júnior

🟡 Pleno

🔒 Seguros

🚫👨‍🎓 Sem graduação necessária

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Lehigh Valley Health Network

SiteLinkedInTodas as Vagas

10.000+ funcionários

🏥 Saúde

⚕️ Seguro de Saúde

Healthcare • Healthcare Insurance

A Lehigh Valley Health Network é um sistema de saúde abrangente que agora faz parte da Jefferson Health, um dos 15 melhores sistemas de saúde sem fins lucrativos dos Estados Unidos. Oferece uma ampla gama de serviços médicos, incluindo cuidados primários, atendimento de urgência e institutos especializados, como o Lehigh Valley Topper Cancer Institute e o Lehigh Valley Heart and Vascular Institute. A LVHN fornece soluções de cuidado extensivas, incluindo visitas por vídeo, segundas opiniões e uma rede de médicos e clínicos em diversos locais. Enfatiza a formação através de residências e bolsas de estudo e prioriza serviços centrados no paciente, como testes laboratoriais e cuidados de saúde femininos. A rede também se foca na inovação, oferecendo ensaios clínicos e terapias avançadas, como a Terapia Celular CAR-T.

Descrição

• Review and manage open Accounts Receivable and document follow-up activities • Resolve underpayments and denials through root cause analysis and corrective action • Escalate accounts and denial trends to management and provider representatives for contracting action • Identify denial and underpayment trends requiring computer system modifications • Prepare reports for meetings with provider representatives and senior leadership • Evaluate underpayments against insurance carrier reimbursement requirements and clinical/payment policies • Apply LVHN insurance contract terms to claim payment reviews • Calculate and submit adjustment and refund requests with appropriate codes and documentation • Determine patient responsibility for non-covered services, co-pays, deductibles, and co-insurance within timely filing limits • Maintain issue logs and account examples for insurance carrier meetings • Review emails and correspondence within 24–48 hours and distribute patient and insurance carrier mail appropriately

🎯 Requisitos

• High School Diploma/GED • 2 years of professional or facility billing and/or collections for all major third party payers, or work experience in a healthcare-related field • Excellent follow-up and verification skills • Excellent verbal and written communication skills • Knowledge of insurance contracts and regulations • Proficient with Microsoft Excel, Word, and PowerPoint • Strong analytical, mathematical, and organizational skills • Successful completion of DOE and Revenue Cycle Education Training within 3 months of hire • Associate’s Degree in Health Care Science, Business, or related field preferred • CPAT - Certified Patient Accounting Technician - State of Pennsylvania preferred • Ability to lift and carry 25 lbs.; frequent sitting/standing and keyboard use

🏖️ Benefícios

• Remote work arrangement • Day Shift • Monday-Friday work schedule, 8:00a-4:30p • Great Place to Work® certified employer • Equal opportunity employment