Insurance Follow-Up Representative

Job not on LinkedIn

🕒 August 6

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔒 Insurance

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 34%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 • Document follow-up activities to resolve underpayments and denials • Conduct root cause analysis of denials and take corrective action • Escalate accounts requiring provider representative contracting action • Identify denial and underpayment trends requiring computer system modifications and recommend corrective action • Prepare reports for meetings with provider representatives and senior leadership • Evaluate underpayments related to insurance carrier clinical and payment policies • Apply LVHN insurance contract terms to claim payment reviews • Determine whether underpayments result from contract management discrepancies, underpayments, or line-item denials • Calculate and submit adjustment and refund requests using appropriate codes and document account history • Identify and allocate patient responsibility for non-covered services, co-pays, deductibles, and co-insurance within timely filing limits • Comply with organizational and departmental policies, procedures, objectives, and goals • Establish issue logs and account examples for insurance carrier provider representative 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 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 applications • Strong analytical, mathematical and organizational skills • Successful completion of DOE and Revenue Cycle Education Training within 3 months of hire • Preferred: Associate’s Degree in Health Care Science, Business or related field • Preferred: CPAT - Certified Patient Accounting Technician - State of Pennsylvania • Ability to lift and carry 25 lbs.; frequent sitting/standing and keyboard use

🏖️ Benefits

• Equal opportunity employment practices • Monday-Friday work schedule, 8:00a-4:30p • Day shift • Remote work in Pennsylvania