Insurance Denials & Reimbursement Specialist

Lehigh Valley Health Network, Inc.; Allentown (Lehigh County); On-site; USD 48,000 - 62,000; Full time

Job summary

Lehigh Valley Health Network, Inc. in Allentown, PA is seeking an Insurance Follow-Up Representative to review and resolve underpayments and denials, applying contract terms and preparing leadership reports.

The role supports collaboration with departments to ensure accurate claim resolutions and timely follow-ups. We seek candidates with 2+ years in healthcare billing/collections, strong follow-up abilities, and proficiency in Excel, Word, and PowerPoint.

Qualifications

• 2 years of professional or facility billing and/or collections experience.
• Excellent follow-up and verification skills.
• Excellent verbal and written communication skills.
• Knowledge of insurance contracts and regulations.
• DOE Revenue Cycle Education Training within 3 months of hire.

Responsibilities

• Works collaboratively with department leadership to review and manage open Accounts Receivable and document follow-up activities.
• Conducts root cause analysis of denials and takes corrective action.
• Prepares reports for meetings with provider representatives and senior leadership.
• Calculates and submits adjustment and refund requests with proper codes and reasons.
• Identifies patient out-of-pocket expenses and allocates responsibility within timely filing limits.

Skills

Billing/collections

Excel

Communication

Insurance contracts

DOE training

Education

High School Diploma/GED

Associate’s Degree Health Care

CPAT - Certified Patient Accounting Technician

Tools

Microsoft Excel

Microsoft Word

PowerPoint

Job description

Lehigh Valley Health Network, Inc. in Allentown, PA is seeking an Insurance Follow-Up Representative to review and resolve underpayments and denials, applying contract terms and preparing leadership reports.

The role supports collaboration with departments to ensure accurate claim resolutions and timely follow-ups. We seek candidates with 2+ years in healthcare billing/collections, strong follow-up abilities, and proficiency in Excel, Word, and PowerPoint.