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Claim Editor and Billing Support Coordinator

Company: St. Luke's University Health Network
Location: Allentown
Posted on: April 9, 2021

Job Description:

Claim Editor and Billing Support Coordinator Allentown, PA - 1110 American Parkway 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 Editor and Physician Billing Support Coordinator is responsible to maintaining the Claims Editor software; including the input of data to create rules for reviewing claims prior to submission to third party insurance companies involving coding and reimbursement guidelines. The Coordinator is also responsible for reviewing all procedure and provider constants entered into the physician practice management system, reviewing and editing charge encounter forms, resolving business office questions concerning coding issues, and reviewing third party rejections. The Coordinator is also responsible for conducting coding seminars for new practice and business office staff.JOB DUTIES AND RESPONSIBILITIES:

  • Maintain the Claims Editor software in order to produce clean claims for submission to third party payers in order to reduce rejections, decrease days in accounts receivable and maximize reimbursement.
  • Review and create rules by keeping abreast of coding and documentation requirements, analyzing third party regulations and publications, and reviewing third party payment rejections and inputting data into the Editor software.
  • Ensuring that edits are timely and accurately corrected by business office personnel.
  • Maintain knowledge of the interface with the physician practice management information system.
  • Prepare reports for feedback to users on edits and develop policies and procedures. Conduct site visits to discuss issues relating to edits.
  • Responsible for reviewing all new procedure codes for the physician practice management system. Maintain current procedure code constants. Assist with provider constants. Coordinate the development and maintenance of charge encounter forms, ABNs, and other forms used by business office and practice personnel relating to charge capture or insurance requirements.
  • Research and resolve business office personnel issues relating to coding, regulations and reimbursement.
  • Conduct monthly coding sessions with new business office and practice personnel.
  • Maintain files relating to job duties.PHYSICAL AND S E NSORY REQUIRE M ENTS:Sitting for up to eight hou r s per day, 3 hours at a ti m e. Standing and walking as necessary. Fingering a n d handling f r equently, twisting and turning of h ands occa s i o nally. Pushing and pulling. Occasionally stoops, bends, squat, kneel and reach above shoul d er le v el. Hearing as it relates to nor m al conversation. Seeing as it relates to general and near vision.EDUCAT I ON:CPC, CCA or CCS-P or COC required. RHIT m ay be considered when applicant possesses applicable physician coding and physi c ian billing experience.TRA I NING AND EX P E RIENCE:At least 5 years experience in physician procedural coding and physician billing/AR follow up. Must possess a working knowledge of ICD-9-CM, CPT and HCPCS coding. Knowledge and experience in dealing with third party insurance co m panies and regulations required. Knowledge and experience navigating the CMS website. For m er experience in training preferred. Microsoft W ord, Excel and P C knowledge required.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. Founded in 1872, St. Luke's University Health Network (SLUHN) is a fully integrated, regional, non-profit network of more than 16,000 employees providing services at 12 hospitals and 300+ outpatient sites. With annual net revenue greater than $2 billion, the Network's service area includes 11 counties: Lehigh, Northampton, Berks, Bucks, Carbon, Montgomery, Monroe, Schuylkill and Luzerne counties in Pennsylvania and Warren and Hunterdon counties in New Jersey. Dedicated to advancing medical education, St. Luke's is the preeminent teaching hospital in central-eastern Pennsylvania. In partnership with Temple University, St. Luke's created the Lehigh Valley's first and only regional medical school campus. It also operates the nation's longest continuously operating School of Nursing, established in 1884, and 38 fully accredited graduate medical educational programs with 347 residents and fellows. St. Luke's is the only Lehigh Valley-based health care system to earn Medicare's five- and four-star ratings (the highest) for quality, efficiency and patient satisfaction. St. Luke's is both a Leapfrog Group and Healthgrades Top Hospital and a Newsweek World's Best Hospital. U.S. News & World Report ranked St. Luke's #1 in the Lehigh Valley and #6 in the state. Two of IBM Watson Health's 100 Top Hospitals are St. Luke's hospitals. St. Luke's University Hospital has earned the 100 Top Major Teaching Hospital designation from IBM Watson Health eight times total and six years in a row. St. Luke's has also been cited by IBM Watson Health as a 50 Top Cardiovascular Program. Utilizing the Epic electronic medical record (EMR) system for both inpatient and outpatient services, the Network is a multi-year recipient of the Most Wired award recognizing the breadth of the SLUHN's information technology applications such as telehealth, online scheduling and online pricing information. St. Luke's is also recognized as one of the state's lowest cost providers.

Keywords: St. Luke's University Health Network, Allentown , Claim Editor and Billing Support Coordinator, Accounting, Auditing , Allentown, Pennsylvania

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