A robust history of health insurance administration, physician support, and an affiliation with one of Pennsylvania’s largest health care networks places Populytics in a one-of-a-kind category. We not only have advanced informatics and analytics capabilities, we also have the resources to put the information uncovered into action in the real world. Our alignments with physicians and providers give us the unique capacity to educate and integrate these insights in the physician-patient setting. And our partnerships with some of the nation’s largest health insurance payers affords us the tools and scope needed to make an impact.
Through long-term involvement with the numerous avenues of health care combined with advanced analytics technology, Populytics offers comprehensive service, unmatched experience, and a viable pathway to efficient, cost-effective health care.
Job Description: Provider and Payer Enrollment Specialist will be responsible for initiating, processing and completing applications for enrollment of Lehigh Valley Physician Group (LVPG) providers with the payers as well as managing the ongoing participation requirements. Specialized focus on accurate and timely updates to internal databases to ensure integrity of information available to specific colleagues network-wide. Job duties include continuous open communication with payer representatives to enroll providers appropriately, respond to inquiries and clarify requirements. Maintains data within multiple internal and external databases for provider and payer enrollment purposes. Motivated to perform duties proficiently under extreme time constraints maintaining a professional demeanor to meet mandatory deadlines. Establishes protocols and has a focused mindset on minimizing potential revenue delays or losses. Demonstrates a strong ability to analyze problems and implement process improvements. Must be able to work in a team oriented environment and have excellent organizational, writing and oral communication skills.
Minimum Requirements: High School Degree or equivalent. Minimum of 5-7 years working in a billing, health insurance, physician practice, or equivalent operations environment. Well developed oral/written communication skills. Effective prioritization of tasks to meet deadlines. Excellent organizational skills. Strong computer literacy skills. Strong orientation to patient/customer satisfaction.
Preferred Qualifications: Associates Degree Preferred. Previous provider credentialing/insurance enrollment experience desired. Knowledge and thorough understanding of the revenue cycle process and how the many components fit together preferred.
Internal Number: 9316
About Lehigh Valley Health Network- Populytics
Lehigh Valley Health Network includes eight hospital campuses - three in Allentown including the region's only facility dedicated to orthopedic surgery, one in Bethlehem, one in East Stroudsburg, one in Hazleton and two in Pottsville, Pa.; 26 health centers caring for communities in seven counties; numerous primary and specialty care physician practices and 18 ExpressCARE locations throughout the region including the area’s only Children’s ExpressCARE at the Health Center at Palmer Township; pharmacy, imaging, home health services and lab services; extensive inpatient and outpatient rehabilitation services; and preferred provider services through Valley Preferred. Specialty care includes: trauma care at the region’s busiest, most-experienced trauma center treating adults and children, burn care at the regional Burn Center, kidney and pancreas transplants; perinatal/neonatal, cardiac, cancer care, orthopedics, and neurology and complex neurosurgery capabilities including national certification as a Comprehensive Stroke Center. The Lehigh Valley Cancer Institute, the Lehigh Valley Heart Institute and the Lehigh Valley Institute for Special Surgery give clinicians of the highest calib...er the necessary infrastructure, programs and partnerships to help community members stay healthy and provide the most advanced treatment when needed. The Lehigh Valley Cancer Institute is a formal member of the Memorial Sloan Kettering (MSK) Cancer Alliance, a transformative initiative to improve the quality of care and outcomes for people with cancer in community health care settings, including access to key MSK clinical trials. Robotic surgery is offered in ten specialties across the health network with more than 10,000 procedures performed since 2007. Lehigh Valley Children’s Hospital, the only children’s hospital and Level 4 NICU in the region, provides care in more than 30 specialties and general pediatrics. Lehigh Valley Hospital–Cedar Crest has been recognized among the top five hospitals in Pennsylvania by U.S. News & World Report for for five consecutive years. Lehigh Valley Hospital–Cedar Crest, Lehigh Valley Hospital–17th Street and Lehigh Valley Hospital–Muhlenberg are national Magnet hospitals for excellence in nursing. Additional information is available by visiting LVHN.org, or following us on Facebook and Twitter.
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