Job Description

Join a team that delivers excellence. Lehigh Valley Health Network (LVHN) is home to nearly 23,000 colleagues who make up our talented, vibrant and diverse workforce. Join our team and experience firsthand what it's like to be part of a health care organization that's nationally recognized, forward-thinking and offers plenty of opportunity to do great work. 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 Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty 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 - Cedar 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 highlight 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 Lehigh Valley Health Network. Summary Adjudicates CDHC (FSA/DCA) claims in accordance with plan(s) provisions and supports Customer Service and other internal and external departments associated with servicing clients. Effectively manages debit card substantiation process through member portal, manual or fax submissions. Reviews and distributes FSA/DCA and HSA reports. Job Duties Handles all facets of the Consumer Driven Health Plans including enrollment, processing claims, and questions/inquiries from Customer Service. Implements new employee benefit/changes. Processes manual/electronic claims for Assigned Child Care, Dependent Care, Health FSA. Debit Card management which includes monitoring Point of Service transactions. Reviews unauthorized refunds, force posts and reissue of lost/stolen cards. Adds spouse/dependents manually when necessary. Investigates and corrects errors identified via report review. Makes corrections/adjustments on Point-of-Service (POS) transactions to member FSA accounts. Effectively manages entire substantiation process for pending debit card transactions including reinstatement of debit card as appropriate. Investigates all checks that have been presented for stale dating, lost or stolen checks, or requests for escheat reporting for clients. Maintains and updates documentation for policies and procedures relating to CDHC department.. Manages, maintains and distributes all reports for FSA/DCA and HSA. Manages and updates user profiles to ensure compliance. Handles all facets of FSA/DCA and HSA analysis required with the implementation of new business to meet timelines. Builds and maintains plan design according to client specifications, Communicates with call center and management to ensure working knowledge and talking points related to unusual circumstances or trends that may result in increased call volume inquiries form plan members or the client. Completes year-end reconciliation analysis, researches discrepancies and outstanding balances, Prepares all reports for clients and submits to management for final distribution. Coordinates with IT colleagues for process improvement of all aspects of CDHC. Minimum Qualifications High School Diploma/GED 3 years of experience in FSA claim processing and claims adjudication. Knowledge of medical terminology. Proficiency in MS Excel, Word, and Outlook. Physical Demands Lift and carry 7 lbs., continuous 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 reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require. Lehigh Valley Health Network is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. All 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. Lehigh Valley Health Network does not accept unsolicited agency resumes. Agencies should not forward resumes to our job aliases, our employees or any other organization location. Lehigh Valley Health Network is not responsible for any agency fees related to unsolicited resumes. Lehigh Valley Hospital

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