Lead Payment Applications

Description

JOB PURPOSE:

Posting, processing and balancing activities related to third party remittances and all forms of payments received from patients. The representative will additionally post refunds, and work with third-party payors to resolve credit issues, as well as act as a leader to other team members. The Payment Applications Team Lead reports to the Manager of Payment Applications.

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Qualifications

MINIMUM EDUCATION REQUIRED:

High School graduate or GED.

Minimum Experience Required

At least one (1) year of related healthcare Revenue Cycle experience, preferably within Payment Applications.

Minimum Licensure/Certification Required By Law

N/A

Additional Preferred Qualifications

At least two (2) years of previous related healthcare Revenue Cycle experience, preferably with a focus in Payment Applications. Prior experience using Epic.

Key Responsibilities

• Liaise appropriately with supervisor to communicate all obstacles, regulatory challenges and system deficiencies that the team faces.
• Perform special projects per supervisor requests.
• Maintain a clear understanding and working knowledge of all information systems required for job scope in order to best be equipped to consistently recognize and troubleshoot problems; assist other team members as necessary.
• Adhere to Piedmont organizational policies and procedures for relevant location and job scope; ensure teams members are maintaining protocols as well.
• Develop super user capabilities in Epic applications and all other related information systems, tools, technologies, and processes; assist other employees as needed to ensure all tools are fully utilized to create an efficient and effective department.
• Identify trends in payment posting and/or payment errors and communicate findings to management.
• Assist team in posting, processing, and balancing all third party payments appropriately in patient accounting system.
• Research credit balances on patient accounts.
• Oversee and verify appropriate posting corrections.
• Ensure that refunds are posted appropriately in patient accounting system.
• Work closely with third-party payors throughout the refund and credit issue resolution processes.
• Verify accuracy in reconciling bank deposits with remittance and payment files.
• Maintain knowledge of insurance payments and rejection/denial processing; communicate with team to ensure all are aware of any new processing practices.
• Manage credit balance/refund worklists to department standards and performance expectations.
• Verify complete, accurate, and timely account notation and documentation in the Revenue Cycle system, including adjudication and denial processing.
• Ensure team maintains a daily focus on attaining productivity standards, recommending new approaches for enhancing performance and productivity when appropriate; assist management with the coordination of daily Payment Application operations.
• Strive for positive patient experience.
• Complete and/or attend mandatory training and education sessions within approved organizational guidelines and timeframes.
• Other miscellaneous duties as assigned.