Insurance Follow-Up & Denials Specialist

Lehigh Valley Health Network, Inc.; Allentown (Lehigh County); Híbrido; USD 52.000 - 70.000; Jornada completa

Descripción de la vacante

Lehigh Valley Health Network is seeking a Billing Specialist to collaboratively review and manage open Accounts Receivable, document follow-up actions, and resolve underpayments and denials. You will analyze denials, escalate when needed, and prepare reports for leadership.

The role requires knowledge of insurance contracts, strong Excel/Word/PowerPoint skills, and excellent communication. DOE and Revenue Cycle training within 3 months of hire is expected.

Formación

• High School Diploma or GED with 2 years of professional or facility billing/collections experience for major third party payers or healthcare field experience.
• 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.

Responsabilidades

• Reviews and manages open Accounts Receivable, documenting follow-up activities to resolve underpayments and denials.
• Performs root cause analysis of denials and escalates to management when needed.
• Prepares reports for meetings with provider representatives and senior leadership.
• Identifies denial and underpayment trends that require system modifications and recommends corrective actions.
• Calculates and submits adjustment and refund requests with appropriate codes and documentation.
• Identifies patient out-of-pocket expenses related to non-covered services, co-pays, deductible, and co-insurance, allocating responsibilities within filing limits.
• Ensures compliance with organizational policies and collaborates with management to establish issue logs for provider discussions.

Conocimientos

Follow-up

Verification

Verbal communication

Written communication

Insurance contracts knowledge

Microsoft Excel

Microsoft Word

PowerPoint

Analytical skills

Mathematical skills

Organizational skills

Revenue Cycle training

Educación

High School Diploma or GED

Associate degree

DOE and Revenue Cycle Training

Herramientas

Microsoft Excel

Microsoft Word

PowerPoint

Descripción del empleo

Lehigh Valley Health Network is seeking a Billing Specialist to collaboratively review and manage open Accounts Receivable, document follow-up actions, and resolve underpayments and denials. You will analyze denials, escalate when needed, and prepare reports for leadership.

The role requires knowledge of insurance contracts, strong Excel/Word/PowerPoint skills, and excellent communication. DOE and Revenue Cycle training within 3 months of hire is expected.