Work Type: Active - Benefit Eligible and Accrues Time Off Exempt: No
Work Schedule: Monday - Friday Work Hours per Biweekly Pay Period: 80
Location: Business Center, US:FL:Lakeland
Summary: Support the day to day operation of the follow-up team on all medical billing and claims activity initiated within a centralized business office. The team leader is a working member of the team, responsible for thoroughly managing assigned claims with accuracy and on a timely basis for achieving the appropriate reimbursement for services rendered.
Detailed responsibilities: * People At The Heart Of All We Do - Fosters an inclusive and engaged environment through teamwork and collaboration. - Ensures patients and families have the best possible experiences across the continuum of care. - Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created. * Safety And Performance Improvement - Behaves in a mindful manner focused on self, patient, visitor, and team safety. - Demonstrates accountability and commitment to quality work. - Participates actively in process improvement and adoption of standard work. * Standard Work Duties: LRHPG Team Leader- RDA - Assist in developing a system to prioritize follow up work based on payer mix, dollar amount (in descending order), & aged A/R. - Maximize technology use for timely productivity on claims follow-up and status review - Utilize payer websites regularly to optimally perform assigned duties as assigned, and reporting any accessibility issues to supervisor immediately to regain site access - Follow set guidelines for the appeals process set by payers, and ensures that claims are contested on a timely manner - Follow guidelines set by payers to appeal any denied claims on a consistent and timely basis. - Proactive approach to communicate errors to the appropriate staff, clinics, physicians, and management. - Follows the D&A Supervisor's directives on types of accounts (government or nongovernment) to work. - Reviews high dollar, aged accounts, and appealed accounts for follow up. Contacts insurance companies as necessary to ensure the appropriate resolution date, payment date, and/or appeal resolution data - Educate others within the organization as billing errors are identified to prevent future instances - Audits payments for insurance accuracy and develops a system to re-submit under and over-paid claims * Stewardship - Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities. - Knows and adheres to organizational and department policies and procedures. * Supervisor/Team Lead Capabilities - Demonstrates accountability for shift/team operations and care/service delivery to support achievement of organizational priorities. - Coaches front line team members to support ongoing professional development and hardwire technical and professional capabilities. - Creates a high performing team by building strong relationships, delegating work and nurturing commitment and engagement. - Manages team conflict/issues implementing appropriate corrective actions, improvement plans and regular performance evaluations. - Applies change management best practices and standard work to support departmental changes and ensure effective team transition. - Promotes a healthy and safe culture to advance system, team and service experience.
Certifications Preferred: Medical Billing and Coding certification Experience
Essential: Minimum of 5+ years of recent insurance/Medical A/R collections experience required. Experience with billing and coding in a physician practice required. Excellent computer skills with prior exposure to use of Microsoft Office suite. Experience in customer service field with a medical setting.