Team Lead, Hospital Billing

Job Purpose

The Team Lead, Hospital Billing will provide expertise and technical resources to support team members of the Billing team in the form of A/R management and analysis, training, report generation, and client interactions.

Duties and Responsibilities

• Monitor and analyze account activity and provide ongoing reporting to regarding status of activities, trends, and account inventory, productivity, and other related measures
• Identify account, data, and/or inventory issues or problems and take necessary steps to resolve issues in accordance with established policies and practices or coordinate the efforts of those responsible for problem resolution
• Produce reporting requested by management to assist in the management of the receivable
• Perform evaluation of claims processed in company or hospital systems by insurance representatives to ensure consistent monitoring of account follow up by representatives in accordance with quality standards and regulatory guidelines, and document
• Identify, document and report payer (insurance carriers or patients) trends and provide advice and support to team members and management regarding specific payer issues
• Serve as technical resource to team members to resolve issues to ensure continuity of collection efforts
• Post and update account data to systems and client systems to ensure systems are accurate and current
• Routes claims for appropriate insurance, or patient follow-up to staff or hospital department
• Provides training and guidance to team members to enhance billing resolution skills
• Serves as point person in the absence of supervisor or other leadership regarding collections efforts, escalated calls, or operational system issues
• Assists management with payer meetings by preparing necessary data and participating in the meetings upon request
• Initiate communication with Liaisons and member hospital representatives to confirm data and resolve claims discrepancies
• Answers escalation or supervisor calls as necessary
• Other duties as assigned
• 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
• Minimum of 5 years’ experience in a related role
• Strong working knowledge of Microsoft Office applications
• Working knowledge of the healthcare reimbursement process
• Strong working knowledge of various payer and hospital systems
• 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

• 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.