Audit Clinical Data Coordinator

Lehigh Valley Hospital, Inc.; Allentown, Northern (Lehigh County, KY); Hybrid; USD 42,000 - 64,000; Full time

Job summary

Lehigh Valley Health Network is seeking an Audit Compliance and Data Coordinator to support clinical audit teams with data organization, reporting, and follow-up of RAC and third-party requests.

The role emphasizes data-driven analysis, documentation, and timely communication to management, with opportunities to collaborate across departments and participate in vendor meetings.

Qualifications

• High School Diploma or GED required.
• Minimum 3 years in a hospital or healthcare administrative setting.
• Strong ability to manage multiple tasks, deadlines, and requests.
• Proficient with Microsoft Office and data/reporting tools.
• Excellent reporting, communication, and analytical skills.

Responsibilities

• Analyze data of requested claims and identify RAC audit trends to prepare reports.
• Log audit and claim denial requests, review findings, and maintain tracking databases.
• Identify workflow bottlenecks and recommend improvements to management and software vendors.
• Develop and maintain relationships with clients, staff, and management through meetings and communications.
• Create educational materials on audit-tracking software and provide staff training.

Skills

Data analysis

Reporting

Time management

Communication

Multitasking

Education

High School Diploma/GED

Associate’s Degree (preferred)

Tools

Microsoft Office

Job description

**Join a team that delivers excellence.**Lehigh Valley Health Network (LVHN) is home to nearly 23,000 colleagues who make up our talented, vibrant and diverse workforce.Join our team and experience firsthand what it's like to be part of a healthcare organization that's nationally recognized, forward-thinking and offers plenty of opportunity to do great work.Imagine a career at one of the nation's most advanced health networks.Be part of an exceptional healthcare 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 healthcare possible every day.Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network. **Summary** Works with all clinical audit teams, compliance department, and specific departments to maintain an organized and timely logging, gathering of documentation, tracking, and follow-up of all audits including recovery audit contractor and any third-party request activities. Follow-up and support data, manages the data and organization, and administrative needs to all clinical audit teams to help with reporting of data and identifying trends. **Job Duties*** Analyze data of requested claims and applies critical analytic thinking to identify pre and post-pay audit trends and claim denial trends by facility location, payers, and services lines to prepare reports to reflect RAC audits, insurance, and third-party activities and claim denials.* Logs all audit and claim denial requests, review findings, and determinations into the audit and tracking data base and evaluate logging and tracking processes and log all claim denials.* Identify workflow road blocks and makes recommendations to management and software vendor.* Develops and maintains a productive client, staff, and management relationships through individual contacts, events, and group meetings.* Communicate the results of audit activities via written report and oral presentation to management.* Completes follow-up and closing of audits.* Creates educational materials on use of audit tracking software and provides ongoing training to staff.* Works, reviews, and files all mail coming in via fax/scanning/e-mail and assign to most appropriate work queues for the Audit Compliance and Data Coordinator team to work.* Coordinators sending of appeals via RightFax while creating a database of all appeals sent.* Assist clinical audit and follow-up teams with write-offs and assigned to management work queue.* Attend monthly insurance/payer vendor meetings to ensure up to date information on policy updates/billing updates/etc. Maintains open communication with insurance/vendor representatives. **Minimum Qualifications*** High School Diploma/GED* 3 years 3 years in a hospital or healthcare administrative secretarial or office management enviroment* Ability to handle multiple tasks, deadlines, and requests utilizing appropriate time-management skills.* Ability to organize and conduct effective reporting and communication to assist management in the analysis of RAC and other third-party request activities.* Computer skills and working knowledge of Microsoft Office and other computer-based applications in order to create and maintain spreadsheets, databases, and perform word processing functions.* Extensive skill in planning and maintaining composure under pressure while meeting multiple deadlines.* Skill in compiling, summarizing, and analyzing complex data, and evaluating information and drawing logical conclusions. **Preferred Qualifications*** Associate’s Degree **Physical Demands** Lift and carry 7 lbs., continuous sitting >67%, frequent keyboard use/repetitive motion, frequent fine motor activity/wrist position deviation. 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.