Job designation.
The Lead Billing Specialist serves as the technical expert regarding revenue cycle and claims management functions. Computer, analytical, written, and verbal communication skills required. Must be able to function in a fast-paced work environment, multitask, and appropriately prioritize work. Must demonstrate ability to contribute to a positive work environment as well as project a courteous and professional demeanor towards the interdisciplinary team. Assist supervisor in administration of billing area to include billing and follow-up coverage for staff vacancies; research of billing issues; assigned projects; staff training.
Qualifications
1. High school diploma or equivalent
2. Minimum 5 years of experience in healthcare billing
3. Individual should have demonstrated continual leadership in their current position including self-directed knowledge development in systems, payor guidelines and software applications
4. Excellent attention to detail, problem solving and critical thinking
5. Must have a team player mindset with adaptability to monitor own work
6. High degree of professionalism and customer service
7. Excellent written and oral communication skills
8. Advanced working knowledge of Microsoft Excel or equivalent, as demonstrated through TRCS-administered Microsoft Excel Proficiency Evaluation
9. Advanced working knowledge of Microsoft Word as demonstrated through TRCS administered Microsoft Word Proficiency Evaluation
10. Communication – Communicates clearly and concisely, verbally and in writing
11. Customer orientation – Establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
12. Interpersonal skills – Able to work effectively with other employees, patients and external parties
13. PC skills – Demonstrates proficiency in PC applications as required
14. Policies & Procedures – Demonstrates knowledge and understanding of organizational policies, procedures and systems
15. Basic skills – Able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately
Principal Job Responsibilities
1. Demonstrate a thorough understanding of the responsibilities associated with each role in the business office.
2. Work closely with direct leadership and clients to develop a structured training program
3. for the TBO team and client’s teams as needed.
4. Work closely with direct leadership and clients to write curriculum and develop course materials.
5. Coordinate implementation of an orientation process for new TBO team members.
6. Ensure orientation is documented and that the documentation is routed to the team member’s personnel file.
7. Conduct training and train-the-trainer sessions to prepare Site Support Specialist, Project Managers, and TBO to assist with ongoing training needs.
8. Supports TBO Leaders in coordinating implementation of an annual competency assessment for TBO team members.
9. Supports TBO Leaders in ensuring TBO team competency assessments are documented and that the documentation is routed to the team members’ personnel files.
10. Work closely with the TBO leadership to create new policies and procedures and/or update existing policies and procedures as the need arises.
11. Communicate process updates/changes, schedule adjustments, and other feedback to TBO team members.
12. Develops a useful and statistically valid method of tracking and reporting data (e.g., by department, payer class, rejections, etc.), to provide relevant management information to track problems and measure improvement.
13. Demonstrates and maintains proficiency in client or TBO systems and procedures, produces ad-hoc reports, and makes recommendations for ensuring correct and timely management of client AR on a routine basis. a. Identifies specific areas of billing/reimbursement concerns by: b. developing a report to capture all accounts c. identify problems, whether billing or insurer payment processing d. research method of correcting problems, internal or external e. takes corrective action to fix internal problems f. contacts insurance company to have accounts reprocessed g. monitors all account activity until project is complete h. monitors problem to ensure it is corrected
14. becomes specialist in this billing area, and then trains specific client or TBO staff
15. Research rejected and denied claims; reconciles with original claim; makes any necessary corrections; resubmits new claims, or resubmits appeals for reconsideration, as appropriate to the situation
16. Regularly meet with the Senior Director to discuss and resolve reimbursement issues or billing obstacles.
17. Assumes first line billing responsibilities in the event of staff vacancies.
18. Communicates effectively with clients, providers and patients regarding claims/billing questions or complaints.
19. Consistently demonstrate a competent, courteous, and professional demeanor and lead the team by example.
20. Maintains goodwill with both patients and insurance companies; responds on a timely basis and ensures all issues are resolved according to established guidelines and required laws and regulations.
21. Completes work with excellent attention to detail to ensure compliance with departmental/company/HIPAA standards.
22. Maintains strict confidentiality of information at all times. Perform other duties as assigned.
Physical Requirements
1. Job duties are generally performed in a clean and well-equipped area with uniform temperatures and normal noise levels
2. Work alternates between sitting and standing with mobility necessary
3. Average sight, talking, hearing and touching are necessary
4. Must be able to drive between facilities and specific locations as needed.
The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required
Job Type: Full-time
Expected hours: 40 per week
Schedule:
- 8 hour shift
- Monday to Friday
Experience:
- Medical billing: 5 years (Preferred)
Work Location: Remote
Job Type: Full-time
Pay: $21.00 - $22.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- AD&D insurance
- Dental insurance
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
- Work from home
Experience level:
Schedule:
- 8 hour shift
- Monday to Friday
Supplemental pay types:
Experience:
- Accounting: 1 year (Preferred)
- Microsoft Excel: 1 year (Preferred)
Work Location: Remote