Description
General Summary of Position
MedStar Health is looking for a Team Leader Patient Accounting to join our Central Financial Clearance team. We are specifically looking for a candidate with strong experience and knowledge with insurance verification and insurance authorization processes. Candidate must have high level experience using Microsoft Excel including pivot tables, filtering, formulas, etc. Position is remote, Monday - Friday, 7:00am - 3:30pm schedule with the possibility of weekend work on occasion.
Central Financial Clerance Team - The CFC Inhouse Team is responsible for verification of insurance benefits and obtaining inpatient authorization for all emergency admissions from the 10 MedStar Health hospitals. This team is also responsible for reviewing the length of stay approval from the payer prior to releasing the accounts for billing.
Job Summary - Provides guidance and assists staff with review and analysis of various reports in assigned area. In cooperation with Supervisor, identifies and analyzes errors to determine action needed for performance improvement. In conjunction with level II Insurance Specialists, assists in researching and addressing administrative customer service issues. Works with all team members to resolve multiple primary and secondary billing, collection, customer service issues with payers and patients.
One of the following certifications required within 1 year of hire date: Certified Revenue Cycle Specialist - CRCSI; Cert Revenue Cycle Rep - CRCR; Cert Revenue Cycle Prof-Instit - CRCP; Cert Revenue Cycle Executive - CRCE; Certified Compliance Technician- CCT; Certified Revenue Integrity Professional- CRIP; CHAM - Certified Healthcare Access Manager; CHAA - Certified Healthcare Access Associate; Hospital Presumptive Eligibility- HPE; Cert Healthcare Fin Prof - CHFP
Primary Duties and Responsibilities
Assists with the daily audit and review of reports to ensure that verification completed. May monitor the error tracking and other statistical reporting systems, communicates to supervisor any trends or problem areas. Investigates, monitors, and consults with supervisor and makes recommendations to address untimely follow-up of accounts.Assists with the daily/weekly/monthly audit of accounts to ensure that accounts meet department standards. Makes recommendations to supervisor to improve the effectiveness of verification efforts, reporting any problems or issues with the process.Assists with review and analysis. Maintains ongoing knowledge of specified forms including state required forms and filing requirements. Communicates problems and issues relative to eligibility conversion to appropriate parties. Acts as a liaison between staff, agency and state to resolve issues.Reviews daily reports to insure completion of verification process and readiness of all accounts for and ensuring a standard turnaround time of scheduled services and based on the payer specific requirements for all unscheduled services. Reviews accounts to determine action required, utilizes all resources and documentation.Assists the supervisor with the development of financial, operational, customer service and productivity targets. Assists with selection, training and orienting of department staff. Assists with compiling and maintaining an updated training manual. Provides training to staff including training team members in the specific work applications and computer Systems used for department.May assist with the formal performance reviews and provides feedback to Manager in accordance. Provides timely and appropriate verbal counseling of staff when they deviate from department standards; in conjunction with Manager, assists in the development of measures to improve performance.May complete timecards and maintains attendance records. Coaches and counsels staff. Initiates or makes recommendations to the supervisor for personnel actions (terminations, suspension, evaluations, interviewing, etc.). May conduct staff meetings on a regular basis. Keeps staff informed via in service meetings and memorandums.Identifies and evaluates staff productivity and base workload assignments, in conjunction with Supervisor, to determine that appropriate allocation of resources, standards and staff performance is optimized.May supervises the day-to-day activities of the assigned staff to accomplish the established monthly and quarterly financial and productivity goals. Establishes priorities, schedules, distributes daily workload and reassigns tasks as necessary.May be accountable for securing information over the phone from the patient or insurance company including pre-collection and preregistration on accounts. Monitors the telecommunications system by measuring voice mail messages, voice mail abandonment, duration of calls taken per representative and duration that each patient is held in queue, etc.Accountable for securing information over the phone from the patient or insurance company including precollection and preregistration on accounts.Assists with the daily audit of accounts that appear on the DNFB Discharge Not Final Billed and the Outpatient Exception Report for accounts > 3 days since discharge to ensure that accounts meet department standard of 72 hours. Makes recommendations to supervisor to improve the effectiveness of verification efforts, reporting any problems or issues with the process.Reviews reports daily to insure completion of verification process and readiness of all accounts for billing (Aged Out-Patient Billing Exception Report, Accounts by F.C. on IP Accounts not Final-Billed due to Lack of Verification, Temporary Accounts with Charges and the AlphaDI) and ensuring a standard turnaround time of 14 days of scheduled services and based on the payer specific requirements for all unscheduled services.
Minimum Qualifications
Education
- High School Diploma or GED required
- Associate's degree in healthcare preferred with courses in Accounting, Finance and Healthcare Administration preferred
- One year of relevant education may be substituted for one year of required work experience.
Experience
- 1-2 years experience in patient accounting in a hospital-based department (systems, billing, medical records, registration, finance) required
- Knowledge of medical terminology and payer billing preferred
- Leadership experience preferred
- One year of relevant professional-level work experience may be substituted for one year of required education.
Knowledge, Skills, and Abilities
- Detailed working knowledge and demonstrated proficiency in the major (Medicare, Medicaid and Blue Cross) payer's application billing and/or collection process, with particular focus on billing specifications and contractual arrangements and/or multiple payer's insurance verification and pre-certification guidelines.
- Ability to resolve complex payer issues to completion, training individuals in the billing and collection processes.
- Excellent communication and interpersonal skills.
- Excellent organizational skills to manage multiple tasks in a timely manner.
- Proficient use of hospital registration and/or billing systems, and Microsoft Word and Excel software applications.
This position has a hiring range of $20.17 - $33.21
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