Billing & Collections Team Lead

The Billing & Collections Team Lead has the primary responsibility of monitoring patient billing practices, policies, billing and collections staff, and workflow processes to maximize reimbursement.  The Billing & Collections Team Lead will also serve as back-up to the Patient Financial Services Supervisor when needed. Interacts with patients and staff in a professional manner, promotes teamwork, and creates an environment where a positive patient experience is a requirement.

Must be willing to receive all required vaccinations i.e flu shot etc. 

1. Work with Revenue Cycle Leadership to ensure that billing and collections procedures are efficient, effective, and timely to maximize reimbursement.
2. Assist Revenue Cycle Leadership with onboarding and training of new employees and ongoing education of current staff.
3. Assist Revenue Cycle Leadership with maintenance of systems and applications that support hospital claim processing in order to maintain accounts receivable inventories at acceptable levels.
4. Assist with claim rejection analysis and implementing procedures and system enhancements to prevent recurrences.
5. Keep updated on and inform staff and leadership with any changes in third-party regulations, bulletins, and policy updates, including commercial managed care and governmental agencies, such as Medicare, and Medicaid.
6. Assist with researching refund requests and credit balances to ensure that adjustments are correct and overpayments are refunded accurately to payors.
7. Assist with reconciliation of unapplied payments (payments not immediately identifiable when received by payors) to ensure that all cash is appropriately posted.
8. Maintains required logs for financial reporting and reconciliation.
9. Review Swing Bed referrals for financial approval.
10. Assist with filing of quarterly Credit Balance Reports (Medicare/Medicaid).
11. Review and split Medicare claims (rollovers).
12. Maintain user access to payor websites/applications.
13. Notifies Revenue Cycle leadership of any unusual or significant issues that may affect accurate and/or timely filing of claims or cash flow.
14. Serve as back-up in absence of the Patient Financial Services Supervisor.
15. Maintains confidentiality.
16. Supports the hospital and promotes a positive attitude.
17. Adheres to dress code, appearance is neat and clean.
18. Wears identification while on duty
19. Adheres to the HIPAA and privacy policies and procedures. Reports any violation or appearance of violation of the policies and procedures and/or laws and regulations addressed in the Compliance Plan and the hospital Code of Conduct to the Compliance Officer, a member of Senior Leadership, or to the Department Director.
    

Average Hours: FT - 36 - 40 hrs/week

Experience:

• 5 years of experience in hospital business office experience, including computerized third-party billing of facility and/or professional claims required
• Knowledge of third-party billing requirements required
• 3 years of experience with Meditech and SSI preferred
  

Education:

• High school diploma or general education degree (GED) required
• Post high school courses in insurance billing, data processing, and medical terminology preferred
  

Working Conditions:

• Extensive computer time. May require sitting for long periods, up to 8 hours with encouragement to stand, stretch, or move about occasionally
• Ability to lift a minimum of 25 pounds
• Visual and hearing ability for registering patients and talking on the phone
• General indoor conditions
• Repetitive motion: typing
• Noise: light noise
• Visual acuity
• Good verbal and written communication skills necessary for job requirements