Lead Pre-Certification Team

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
Assists in improving efficiency and effective operations; monitors and coordinates daily processes and workflow. Provides technical support for select computer applications and issues. Communicates with clinical departments relating to precertification matters. Serves as liaison with respective clinical areas and external vendors for payor and precertification requirements. Participates in hiring decisions for open positions within department. Acts as EPIC superuser and participates in ongoing training.

Job Duties

• Assists in the development, implementation, and maintenance of the authorization systems, including external vendor access.
• Assists with the development of the staff assignment schedules and ensures productivity measures are in place and monitored.
• Builds, changes, and modifies procedures and other associated elements in the system as requested by department directors and managers.
• Interfaces with both internal and external customers ensuring maximal patient centered experience.
• Coordinates and provides training for staff for all new releases updates and process changes.
• Seeks to create and modify systems and processes to maximize efficiency.
• Assists with general clerical duties and other departmental priorities as needed.

Minimum Qualifications

• High School Diploma/GED
• 5 years of experience in a physician's office or other specialized medical setting and
• 1 year prior authorization experience.
• Knowledge of medical terminology.
• Knowledge of Microsoft Office Suite.
• Expertise in authorization processes and systems software knowledge, protocols, procedures, and work flow designs.
• Demonstrated leadership qualities.
• Previous knowledge regarding insurance verification, precertification, and authorization requirements.
• Previous demonstrated ability to manage multiple priorities and meet deadlines.

Preferred Qualifications

• Associate’s Degree in business administration or related field.
• Previous knowledge of Epic or PHS.

Physical Demands
Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

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.

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