Job Description
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.
HOURS:
Full Time, 40 hours/week, Days
Mon-Fri, employees may choose a start time between 6 AM and 9 AM
No nights, holidays, or weekends
Home location of St. Luke's Center, Allentown PA with the opportunity to work hybrid remote two days per week, after 6 months on site training, and at the manager's discretion, for PA and NJ candidates.
Assists in the maintenance and updating of the network Charge Description Master (CDM) under the direct supervision of senior level staff members. Responsibilities include ensuring that all hospital services are added to the CDM per established policies and procedures. Involved in Network audit/review initiatives to ensure compliance with third party payer regulations and requirements related to the charge process. Responsible for verifying the accuracy of payments received for services rendered per third party payer contracts/other payment protocols.
JOB DUTIES AND RESPONSIBILITIES:
- Maintain volume within department work queues by collaborating with both clinical and revenue cycle staff throughout the issue resolution process.
- Assists management in the establishment of charges for new procedures, services, and supplies.
- Responsible for the initial pricing of hospital and professional services utilizing various pricing methodologies established for the Network.
- Ensures that the CDM complies with third party coding requirements regarding UB04 revenue codes, HCPCS/CPT codes.
- Assists in the maintenance and updating network CDM to ensure reimbursement maximization.
- Field customer service requests to ensure patient chart documentation supports the charges applied to the patient account.
- Updates Outpatient Workers Compensation Fee Schedules on a quarterly basis.
- Reviews third party correspondence (bulletins, Code Correct Informants, etc.) to identify possible additions and/or revisions to CDM/Epic system.
- Complies with all hospital and departmental policies and/or procedures.
- Maintains confidentiality of all materials handled within the Network/ Entity as well as the proper release of information.
PHYSICAL AND SENSORY REQUIREMENTS:
Sitting for up to 8 hours per day, 3 hours at a time. Consistent use of hands and fingers for typing, telephone, data entry, etc. Occasional twisting and turning. Uses upper extremities to lift and carry up to 10 pounds. Stoops, bends and reaches above shoulder level to retrieve files. Hearing as it relates to normal conversation. Seeing as it relates to general vision. Visual monotony when reading reports and viewing computer screen.
EDUCATION:
Four year degree in health administration, business, or related field is preferred.
TRAINING AND EXPERIENCE:
Two years of CDM maintenance experience is preferred.
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.
Numbers & Facts
| Location | Allentown, PA |
| Industry | Healthcare Services |
| Company Size | 5,000 to 9,999 employees |
About Company
St. Luke's University Health Network is a regional network of hospitals, physicians and other related organizations providing care primarily in Lehigh, Northampton, Monroe, Carbon, Schuylkill, Bucks, Montgomery and Berks counties in Pennsylvania and Warren County in New Jersey.
The Network provides services at more than 150 sites. St. Luke's University Health Network is comprised of six hospital sites. The Network includes:
- More than 80 owned physician-practice sites
- 300 employed primary care/specialist physicians
- Various outpatient testing and service facilities
- Home health
- Hospice services (inpatient and outpatient)
- Largest ambulance provider in Bucks County and second largest in Lehigh County
- Other related organizations
- 57,500+ annual admissions
- 195,000 annual emergency room visits
- 1,325 physicians on the Medical Staff (96 percent board-certified)
- 8,600+ employees
- More than 1,350 volunteers
Areas of exceptional medical expertise include:
- Level 1 Adult Trauma Center: fully accredited by Pennsylvania Trauma Systems Foundation; 2,400+ annual trauma cases; St. Luke's 1.75 percent mortality rate represents top decile performance, significantly better than peer group as measured by National Trauma Data Bank of the American College of Surgeons; aeromedical transport services
- Oncology: first and only cancer program in Pennsylvania to receive American College of Surgeons' highest quality recognition for three consecutive years; only Pennsylvania program to receive award in 2010; region's only fellowship-trained surgical oncologists; advanced programs for melanoma (internationally recognized melanoma investigator), lung, breast, prostate, gynecologic and gastrointestinal cancers and tumors of the brain and spine
- Cardiology and Cardiovascular Surgery: multiple-year recipient of highest rating for cardiac bypass surgery, represents top decile performance achieved by only 10 percent of U.S. hospitals (Society for Thoracic Surgery); region's first Joint Commission certified Heart Failure Program; comprehensive surgical services excluding heart transplants
- Neuroscience: accredited Stroke Center; additional Centers of Excellence include: Balance Center, Headache Center, Memory Disorders Center, Multiple Sclerosis Center, Sleep Disorders Center
- Orthopaedics: advanced expertise in total joint replacement and reconstruction, computer-assisted minimally invasive surgery, primary and reconstructive surgery of the spine, sports injuries, diseases and conditions of the hand and elbow, traumatic injuries
- Women's/Children's Health: high-risk pregnancy; the region’s busiest obstetrical service; two neonatal intensive care units; pediatric specialty care provided by St. Christopher's Hospital for Children.
- Robotic/Minimally Invasive Surgery: one of the nation's most experienced robotic surgical teams
- Radiology: designated international General Electric Healthcare Show Site for imaging technology; designated Breast Imaging Center of Excellence by American College of Radiology
- Bariatric Surgery: designated Center of Excellence by American Society for Metabolic and Bariatric Surgery and Surgical Review Corporation
St. Luke's offers an exceptional benefit plan for employees. Our values are reflected in all we do for patients, each other and the community:
Pride - We take pride in our accomplishments and in our organization.
Caring - We show consideration for others and their feelings. We treat others as we want to be treated.
Respect - We recognize the value, diversity and importance of each other, those we serve and the organization.
Accountability - We are responsible to make decisions and solve problems in a timely and effective manner.
Flexibility - We adapt to the changing needs and expectations of those we serve.
Teamwork - We work together to improve quality.
The mission of St. Luke's University Health Network 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.
Skills
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