Job Purpose
The Team Lead, Accounts Receivable Services supports the management team with the coordination of activities and operations of Accounts Receivable department.
Duties and Responsibilities
- Assist global team members by answering questions and providing support for their ongoing success
- Provide initial training on the client host system
- Assist in tracking productivity and quality of Accounts Receivable Representatives
- Identify areas of opportunity for improvement through one on one evaluation of Accounts Receivable team
- Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
- Meets and maintains daily productivity/quality standards established in departmental policies and supports training needs identified to ensure teams success in this area
- Meets and maintains quality standards established in departmental policies and supports training needs identified to ensure the teams success in this area
- Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts
- Adheres to the policies and procedures established for the client/team
- Knowledge of timely filing deadlines for each designated payer
- Initiate appeals when necessary
- Identify and correct medical billing errors
- Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process
- Ability to analyze, identify and resolve issues causing payer payment delays
- Ability to analyze, identify and trend claims issues to proactively reduce denials
- Understanding of under payments and credit balance process
- Perform special projects and other duties as needed
- Act cooperatively and courteously with patients, visitors, co-workers, management and clients
- Other duties as assigned by the management team
- Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Understand and comply with Information Security and HIPAA policies and procedures at all times
- Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
Qualifications
- High School diploma or equivalent required
- Experience in insurance collections, including submitting and following up on claims for a Medical Practice, Medical Facility/Medical Billing Company, Ambulatory Surgical Center, and/or Hospital required
- Experience with training new users required
- Knowledge of the denied claims and appeals process required
- Experience with practice management systems. EPIC PB, Allscripts and/or Cerner preferred
- Extensive knowledge of individual payor websites, including Navinet and Novitasphere
- Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes
- Ability to work well individually and in a team environment
- Proficiency with MS Office. Must have basic Excel skillset.
- Strong communication skills/oral and written
- Strong organizational skills
- Work independently from assigned work queues
- Maintain confidentiality at all times
- Maintain a professional attitude
- Proficiency in Microsoft Office Suite
- Strong interpersonal skills, ability to communicate well at all levels of the organization
- Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
- High level of integrity and dependability with a strong sense of urgency and results oriented
- Excellent written and verbal communication skills required
- Gracious and welcoming personality for customer service interaction
Working Conditions
- Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
- Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
- Work Environment: The noise level in the work environment is usually minimal.
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.