Job Description
Imagine a career at one of the nation's most advanced health networks. Be part of an exceptional health care 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 health care possible every day. Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network . Summary Participates in any or all aspects of the claim submission to third party carriers, incorporating industry best practices to ensure all state and federal billing guidelines and regulations are satisfied. Conducts root cause analysis of claim edits to determine corrective action to facilitate timely submission of claims and enhance the clean claim rate. Job Duties Analyzes claim edits and conducts root cause analysis to resolve the edit, identifying opportunities for work flow process improvement and claim logic implementation to enhance the clean claim rate. Monitors claim rejections from insurance carriers, taking the corrective action necessary to resubmit the claim, escalating rejection trends to department leadership for the creation or modification of claim edits, claim rules, or for escalation to the pr
