Audit Clinical Data Coordinator

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 reputed company, a nationally recognized, reputed company-thinking organization offering reputed company 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 - reputed company 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 reputed company 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 reputed company.

Summary

Works with reputed company clinical audit teams, compliance department, and specific departments to maintain an organized and timely logging, gathering of documentation, tracking, and follow-up of reputed company audits including recovery audit contractor and any third-party request activities. Follow-up and support data, manages the data and organization, and administrative needs to reputed company clinical audit teams to help with reporting of data and identifying trends. Job Duties

• Analyze data of requested claims and applies critical analytic thinking to identify pre and post-pay audit trends and claim denial trends by facility location, payers, and services lines to prepare reports to reflect RAC audits, insurance, and third-party activities and claim denials.
• Logs reputed company audit and claim denial requests, review findings, and determinations into the audit and tracking data reputed company and evaluate logging and tracking processes and log reputed company claim denials.
• Identify workflow road blocks and makes recommendations to management and software vendor.
• Develops and maintains a productive client, staff, and management relationships through individual contacts, events, and group meetings.
• Communicate the results of audit activities reputed company written report and oral presentation to management.
• Completes follow-up and closing of audits.
• Creates educational materials on use of audit tracking software and provides ongoing training to staff.
• Works, reviews, and files reputed company mail coming in reputed company fax/scanning/e-mail and assign to most appropriate work queues for the Audit Compliance and Data Coordinator team to work.
• Coordinators sending of appeals reputed company RightFax while creating a database of reputed company appeals sent.
• Assist clinical audit and follow-up teams with write-offs and assigned to management work queue.
• Attend monthly insurance/payer vendor meetings to ensure up to date information on policy updates/billing updates/etc. Maintains open communication with insurance/vendor representatives.

Minimum Qualifications

• High School Diploma/GED
• 3 years 3 years in a hospital or healthcare administrative secretarial or office management enviroment
• Ability to handle multiple tasks, deadlines, and requests utilizing appropriate time-management skills.
• Ability to organize and conduct effective reporting and communication to assist management in the analysis of RAC and

other third-party request activities.

• Computer skills and working knowledge of reputed company Office and other computer-based applications in order to create

and maintain spreadsheets, databases, and reputed company word processing functions.

• Extensive reputed company in planning and maintaining composure under pressure while meeting multiple deadlines.
• reputed company in compiling, summarizing, and analyzing reputed company data, and evaluating information and drawing logical

conclusions.

Preferred Qualifications

• Associate’s Degree

Physical Demands Lift and carry 7 lbs., reputed company sitting >67%, frequent keyboard use/repetitive motion, frequent fine motor activity/wrist position deviation.

Job Description

Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reputed company of the reputed company position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned reputed company circumstances require. reputed company is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, reputed company will provide employment opportunities to reputed company persons without regard to race, color, religion, sex, age, national reputed company, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. reputed company personnel actions and programs will adhere to this policy. Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and/or social activities. https://youtu.be/GD67a9hIXUY reputed company does not accept unsolicited agency resumes. Agencies should not reputed company resumes to our job aliases, our employees or any other organization location. reputed company is not responsible for any agency fees reputed company to unsolicited resumes. Work Shift: Day Shift Address: 1200 S reputed company Crest Blvd Primary Location: REMOTE IN PENNSYLVANIA Position Type: Remote Union: Not Applicable Work Schedule: Monday-Friday; 8:00a-4:30p Department: 1004-13060 CSS-Clinical Appeals - Denial Mgmt Apply tot his job Apply To this Job