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Claims Specialist


At Lancaster General Health, our culture is what sets us apart and creates a lasting impression of our health system in the community and in the hearts of our patients and their families. A role with us is more than just a job, we ask that you Live Your Legacy at LGH by finding your passion in your everyday role, committing to those you serve, and reaching for your personal best.

We are recognized as 1 of only 9 hospitals in the entire country with awards in Medicare.Gov, LEAPFROG and Healthgrades Americas 50 Best Hospitals. We have attained five year Magnet ® recognition status for the fifth time with the American Nurses’ Credentialing Center (ANCC) and we are the 2018 recipient of the Foster G. McGaw Prize in recognition of the commitment to community service.

PENN MEDICINE LANCASTER GENERAL HEALTH offers a comprehensive benefits package:

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program so that our employees can stay actively engaged and committed to living their legacy every day. Together, we will continue to make medical advances that help people live longer, healthier lives.

Join us and be part of a team that empowers you to do more than your job and encourages you to:

Live Your Passion. Live Your Best. Live Your Commitment. Live Your Legacy.

Summary

1.0 FTE
40 hours/week, day shift, no weekend, no holidays

Job Description

HOURS: Full Time (1.0 FTE; 40hrs/wk); day shift with no weekend or holidays.

POSITION SUMMARY: Responsible for the daily review of hospital and physician claims to ensure that bills are submitted timely and compliantly.

ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:

  • Review hospital and/or physician claims that are billed daily for one or more financial classes.
  • Communicate any billing discrepancies with the rendering clinical area and/or Billing Supervisor.
  • Perform appropriate follow-up on any editing claim to ensure timely submission to the payor.
  • Have a thorough knowledge of billing requirements for assigned payor(s).
  • Process requests for rebills.
  • Process requests for itemized bills.
  • Attach any necessary documentation to the bills prior to submission to the payor.
  • Monitor the daily transmission process.
  • Monitor the daily ASC process.
  • Recognize trends/issues and report to Billing Supervisor/Manager.
  • Meet established performance goals and quality assurance standards.
  • Assist other areas of Patient Financial Services as business needs dictate.  Note: billing, cash management, customer services, A/R follow up (regardless of financial class), etc.

SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above:

  • Assist with any special projects as assigned by Billing Supervisor/Manager.

MINIMUM REQUIRED QUALIFICATIONS:

  • High School diploma or equivalent.
  • Strong written and verbal skills.
  • Strong interpersonal skills.
  • Team oriented.
  • Competent in Microsoft Office.
  • A health care provider in good standing with Medicare, Medicaid, and other federal and state health insurance programs, i.e. not excluded from participation in Medicare, Medicaid or any other federal or state health insurance program

PREFERRED QUALIFICATIONS:

  • Knowledge of CPT and ICD-9 coding.
  • 1-2 years experience in billing and/or coding in a hospital or physician office setting.

This position is located in Lititz, PA. #LI-MD1

Benefits of Joining Penn Medicine Lancaster General Health:

PENN MEDICINE LANCASTER GENERAL HEALTH combines a Nationally Ranked Hospital with great schools, safe neighborhoods, affordable housing, local community events and festivals as well as a wealth of cultural and recreational activities. The scenic Susquehanna River Valley provides opportunities for fishing, skiing, kayaking, hiking and mountain biking in addition to easy access to NJ shoreline or Delaware beaches. Urban life is easily accessible, with New York, Baltimore, Philadelphia and Washington D.C. a train ride away. Local universities, Fulton Theatre, the downtown shopping and dining district and local sports teams make Lancaster a great place to Live, Work and Play.

Disclaimer

PENN MEDICINE LANCASTER GENERAL HEALTH is an Equal Opportunity Employer, committed to hiring a diverse workforce. All openings will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion or any other classification protected by law.

 

Search Firm Representatives please read carefully: PENN MEDICINE LANCASTER GENERAL HEALTH is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, all resumes submitted by search firms to any employee at PENN MEDICINE LANCASTER GENERAL HEALTH via-email, the Internet or directly to hiring managers at Penn Medicine Lancaster General Health in any form without a valid written search agreement in place for that position will be deemed the sole property of PENN MEDICINE LANCASTER GENERAL HEALTH, and no fee will be paid in the event the candidate is hired by PENN MEDICINE LANCASTER GENERAL HEALTH as a result of the referral or through other means.

MILL Full Time Posted on 09/08/2021