Claim Editor and Billing Support Coordinator (Remote Work available after training!)

St. Luke's University Health Network

Allentown Pennsylvania

United States

Information Technology
(No Timezone Provided)



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 SENSORY REQUIREMENTS:

Sitting for up to eight 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, squat, kneel and reach above shoulder level. Hearing as it relates to normal conversation. Seeing as it relates to general and near vision.

EDUCATION:

CPC, CCA or CCS-P or COC required. RHIT may be considered when applicant possesses applicable physician coding and physician billing experience.

TRAINING AND EXPERIENCE:

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 companies and regulations required. Knowledge and experience navigating the CMS website. Former experience in training preferred. Microsoft Word, Excel and PC 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.

Claim Editor and Billing Support Coordinator (Remote Work available after training!)

St. Luke's University Health Network

Allentown Pennsylvania

United States

Information Technology

(No Timezone Provided)



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 SENSORY REQUIREMENTS:

Sitting for up to eight 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, squat, kneel and reach above shoulder level. Hearing as it relates to normal conversation. Seeing as it relates to general and near vision.

EDUCATION:

CPC, CCA or CCS-P or COC required. RHIT may be considered when applicant possesses applicable physician coding and physician billing experience.

TRAINING AND EXPERIENCE:

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 companies and regulations required. Knowledge and experience navigating the CMS website. Former experience in training preferred. Microsoft Word, Excel and PC 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.