Insurance Follow-Up Representative

Job not on LinkedIn

🔥 17 hours ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔒 Insurance

🚫👨‍🎓 No degree required

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Lehigh Valley Health Network

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Lehigh Valley Health Network is a comprehensive healthcare system that is now part of Jefferson Health, one of the top 15 not-for-profit health systems in the United States. It offers a wide range of medical services, including primary care, urgent care, and specialized institutes like the Lehigh Valley Topper Cancer Institute and the Lehigh Valley Heart and Vascular Institute. LVHN provides extensive care solutions, including video visits, second opinions, and a network of doctors and clinicians in numerous locations. It emphasizes education through residencies and fellowships and prioritizes patient-centric services such as lab testing and women's health care. The network also focuses on innovation, offering clinical trials and advanced therapies like CAR-T Cell Therapy.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

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