Current jobs related to Claim and Denials Coding Analyst - Allentown - St. Luke's Hospital
-
Coding and Claims Resolution Specialist
2 weeks ago
Allentown, Pennsylvania, United States St. Luke's Hospital Full timeAt St. Luke's Hospital, we take pride in the expertise, dedication, and empathy of our workforce. Our employees are our greatest asset, committed to fulfilling our mission of excellence in caring for the ill and injured, educating healthcare professionals, and enhancing access to care in our communities, irrespective of a patient's financial situation. The...
-
Medicaid Analyst
1 month ago
Allentown, United States Phoebe Ministries Full timeJob DescriptionJob DescriptionMedicaid AnalystFull-time - Allentown, PAPhoebe Ministries is hiring a Medicaid Analyst to join our long-term care facility in Allentown, PA.We show our employees our appreciation for their contribution towards carrying out our mission of enriching the lives of seniors. Phoebe Allentown has a beautiful, updated campus and high...
-
Medicaid Program Analyst
2 weeks ago
Allentown, Pennsylvania, United States Phoebe Ministries Full timeJob OverviewPosition: Medicaid Program AnalystEmployment Type: Full-timeOrganization: Phoebe MinistriesPhoebe Ministries is seeking a dedicated Medicaid Program Analyst to enhance our long-term care services. We are committed to recognizing our employees' vital roles in fulfilling our mission to enrich the lives of seniors. Our facility boasts a modern...
-
Bilingual Claims Customer Service Representative
3 weeks ago
Allentown, United States PMA Companies Full timeAs a member of the Customer Service Center Call Center Team, ensure efficient and timely processing of all work assignments into applicable business systems with strict adherence to all established procedures to assist in the attainment of service level goals throughout the CSC. Responsibilities Provide accurate and timely resolution to claims customer...
-
Claims Customer Service Rep
1 month ago
Allentown, United States PMA Companies Full timeBack Claims Customer Service Rep #4250 Allentown, Pennsylvania Apply Apply for this job now! Apply Job Description: As a member of the Customer Service Center Call Center Team, ensure efficient and timely processing of all work assignments into applicable business systems with strict adherence to all established procedures to assist in the attainment of...
-
Claims Customer Service Rep
2 months ago
Allentown, United States PMA Companies Full timeClaims Customer Service Rep #4250 Allentown, Pennsylvania Apply for this job now! Job Description: As a member of the Customer Service Center Call Center Team, ensure efficient and timely processing of all work assignments into applicable business systems with strict adherence to all established procedures to assist in the attainment of service level goals...
-
Accounts Receivable Specialist
3 months ago
Allentown, United States ST. LUKE'S UNIVERSITY HEALTH NETWORK Full timeSt. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and...
-
Financial Operations Associate
1 week ago
Allentown, Pennsylvania, United States St. Luke's University Health Network Full timeAt St. Luke's, we take pride in the expertise, dedication, and empathy of our workforce. Our employees are our greatest asset, committed to fulfilling our mission of excellence in caring for the ill and injured, educating healthcare professionals, and enhancing access to care in our communities, irrespective of a patient's financial situation.The Accounts...
-
Revenue Cycle Specialist
1 week ago
Allentown, Pennsylvania, United States St. Luke's University Health Network Full timeAt St. Luke's University Health Network, we take pride in the dedication, expertise, and compassion of our workforce. Our employees are our greatest asset, committed to fulfilling our mission of providing exceptional care to those in need, educating healthcare professionals, and enhancing access to medical services for all individuals, regardless of their...
-
Sr Systems Analyst
1 month ago
Allentown, United States Thermo Fisher Scientific Full timeWork Schedule First Shift (Days) Environmental Conditions Office Job Description Thermo Fisher Scientific Inc. is seeking a Sr Systems Analyst with a proven track record of success and experience to join our dynamic team. As a leader in serving science, with annual revenue of more than $40 billion, we are dedicated to enabling our customers to make the...
-
Allentown, United States Uline Full time**Supply Chain Analyst** **Supply Chain Analyst** Job ID: R220903 Location: Allentown, Pennsylvania **Supply Chain Analyst** **Pennsylvania Branch** **700 Uline Way, Allentown, PA 18106** Uline: Where hard work and hustle are valued and rewarded. **Position Responsibilities** * Act as the liaison between Uline's Corporate and PA branch regarding all supply...
-
Charge Capture Analyst
2 months ago
Allentown, United States St. Luke's Hospital Full timeSt. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other...
-
Systems Analyst/Administrator
5 days ago
Allentown, United States ESSA Bank and Trust Full timeThe Systems analyst/Administrator’s role is to ensure the stability, integrity, and functionality of ESSA Bank and Trust’s server, storage, and virtualization systems.Work involves overseeing the day-to-day operations of the enterprise systems, providing applications support and patch management. Manages multiple financial applications and when...
-
Dental Insurance Billing Specialist
1 day ago
Allentown, Pennsylvania, United States Nurture Dental Health PC Full timeAbout the RoleWe are seeking a highly skilled and experienced Insurance Billing Coordinator to join our team at Nurture Dental Health PC. As a key member of our staff, you will be responsible for overseeing, submitting, tracking, and recording all insurance billing for our single-doctor practice.ResponsibilitiesSubmit electronic and manual claims to...
-
Medical Biller
3 months ago
Allentown, United States Surgery Center of Allentown LLC Full timeJob DescriptionJob DescriptionThe Surgery Center of Allentown, located in Allentown, PA., is a freestanding ambulatory surgery center. At the Surgery Center of Allentown, we provide high quality outpatient surgical care to the people of the Lehigh Valley and surrounding areas in a pleasant and convenient environment.We are currently searching for a full-time...
-
Project Materials Analyst
3 months ago
Allentown, United States Air Products Full timeAt Air Products, our purpose is to bring people together to reimagine what's possible, collaborate and innovate solutions to the world's most significant energy and environmental sustainability challenges. Grow with us as we embark on building tomorrow together by being the safest, most diverse and most profitable industrial gas company in the world....
-
Project Materials Analyst
3 months ago
Allentown, United States Air Products Full timeAt Air Products, our purpose is to bring people together to reimagine what's possible, collaborate and innovate solutions to the world's most significant energy and environmental sustainability challenges. Grow with us as we embark on building tomorrow together by being the safest, most diverse and most profitable industrial gas company in the world. ...
-
Medical Biller
3 months ago
Allentown, United States Surgery Center of Allentown LLC Full timeJob DescriptionJob DescriptionThe Surgery Center of Allentown, located in Allentown, PA, is a freestanding ambulatory surgery center. At the Surgery Center of Allentown, we provide high quality outpatient surgical care to the people of the Lehigh Valley and surrounding areas in a pleasant and convenient environment.We are currently searching for FT Billing...
-
Behavior Analyst
1 month ago
Allentown, United States Access Services Full timeAccess Services is seeking a full-time Board Certified Behavior Analyst (BCBA) in Lehigh County. Our Behavior Analysts have a base salary of $72,000, and we offer additional incentive pay of $80 to $100/hourly for billable hours beyond an 80 hour/4-week cycle. WORK/LIFE BALANCE is important to us! That is why we only require 20 billable hours per week. With...
-
Behavior Analyst
2 weeks ago
Allentown, United States Access Services Full timeAccess Services is seeking a full-time Board Certified Behavior Analyst (BCBA) in Lehigh County. Our Behavior Analysts have a base salary of $72,000, and we offer additional incentive pay of $80 to $100/hourly for billable hours beyond an 80 hour/4-week cycle. WORK/LIFE BALANCE is important to us! That is why we only require 20 billable hours per week. With...
Claim and Denials Coding Analyst
1 month ago
St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.
The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services, FQHC, MSO, and ASCs across the network. Utilizes provider documentation and queries, coding software tools and Insurance carrier medical and reimbursement policies during the claim review process.
JOB DUTIES AND RESPONSIBILITIES:
Maintain current knowledge of coding, compliance, and documentation guidelines
Resolve Charge Review and Claim Edit CCI/LCD edits, diagnosis coding errors and MUE frequency for clean claim submission
Resolve coding denials through claim correction or appeal. Claim corrections will be made after review of supporting documentation, CCI/LCD, carrier policy and utilization of coding software applications. The appeals process may include collaboration with the Claim Editing Manager, Physician, Specialty Coder, AR specialist or Auditor/Educator. Demonstrate the ability to formulate an appeal rationale based on clinical documentation, application of LCD, relative carrier policy and published Academy or Societal guidance
Provide coding guidance to providers and charge entry staff for single or low volume errors. Report high volume coding denial trends to the coordinator
Maintain meticulous documentation, spreadsheets, account, and claim examples of root cause issues. Performs searches of governmental, payor-specific, guidelines to identify and coding and billing requirements to make recommendations
Review TCM Charge Review encounters to verify the documentation supports all required TCM components. Relevel TCM service when not supported by the documentation or TCM has been rendered during another TCM 30-day period
Attends coding conferences, workshops, and in house sessions to receive updated coding information and changes in coding and/or regulations
Assists with training new staff in all aspects of the Analyst role.
PHYSICAL AND SENSORY REQUIREMENTS:
Sitting for up to 8 hours per day, 3 hours at a time. Standing and walking as necessary. Fingering and handling frequently, twisting and turning of hands occasionally. Pushing and pulling. Occasionally stoops, bends, squats, kneels and reach above shoulder level. Hearing as it relates to normal conversation. Seeing as it relates to general and near vision.
EDUCATION:
CPC or CCA certification required.
TRAINING AND EXPERIENCE:
At least 2 years of active E&M and/or Surgical Coding experience required. Must possess a comprehensive knowledge of ICD-10-CM, CPT and HCPCS coding. Knowledge and experience in dealing with third party insurance companies relative to claim processing and coding denials follow up. Epic Resolute experience helpful
Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's
St. Luke's University Health Network is an Equal Opportunity Employer.