Team Lead, Patient Financial Services Specialty

2 weeks ago

Janesville, United States Mercyhealth Full time

Overview:

- Specialty Group Team Lead, Patient Accounts, Days, 80 Hrs / wks
- Location: MercyCare Bldg; Janesville, WI or Rockton Ave Campus; Rockford, IL. Hybrid schedule opportunities available after probationary period.

Works in collaboration with the leadership team on communicating Specialty billing policies, procedures and providing department workflow training and reporting to all partners. Conducts performance audits and provides respective partner feedback along with additional training as needed to help support in partner development. Works all advanced functions within Epic and performs other duties as assigned.

**Responsibilities**:

- Serves as A Subject Matter Expert (SME) with regards to the Specialty billing processes and the respective Patient Financial Services Specialty role, maintaining an advanced knowledge of payor updates including Federal and State guidelines, department workflows and resources needed to resolve payor rejections and troubleshoot identified denial trends.
- Knowledgeable in the Single Billing Office (Both HB and PB) environment within Epic.
- Conducts and manages all department workflow training for new hires to ensure the 90-day standards are successfully met.
- Escalates and follows-up with various Mercyhealth departments on any open and unresolved items to assure timely submissions on outstanding claims
- Monitors and works interdepartmental communication work queues to help ensure timely follow-up and resolution to department/patient open items.
- Investigates and works identified payor trends to help present a recommended resolution to improve payment outcomes.
- Develops written workflows and job aids to help provide additional resources to Specialty Representatives.
- Partners with the Revenue Cycle Training department to host shadowing sessions for new partner orientations to help aid in sharing general knowledge about the role and impact it has within the revenue cycle.
- Assists with the review and approval of department adjustment requests, ensuring appropriate follow-up was completed and correct adjustment codes were selected, providing partner feedback where applicable.
- Researches and provides ongoing partner education regarding regulatory compliance and requirements for claim submission.
- Ensures accurate and timely completion of daily tasks and projects.
- Works with the supervisor to develop and maintain individual and work group statistics that measure quality and productivity.
- Performs partner audits on a regular basis to ensure quality and accuracy of partner work productivity
- When applicable, identifies and takes appropriate action to resolve problems to ensure that Mercyhealth obtains expected reimbursement. Brings workflow discrepancies to the attention of a supervisor or manager.
- Provides daily support to work group partners by being available to answer questions and gives direction on workload.
- On occasion, with the coordination of a supervisor, adjusts workload.
- Serves as a backup to other leads within their team, assisting as needed.
- Special projects as assigned.

Education and Experience:
High school diploma or equivalent required.

Associates degree in a business or healthcare field preferred.

Five years of healthcare experience required, with emphasis in billing, insurance, collections, registration, scheduling, or customer service.

Undertakes self-development activities

Certification/Licensure:
Epic billing or HFMA CRCR certification (or comparable certification)

Special Physicial Demands:
While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is frequently required to sit. The employee is occasionally required to stand; walk; climb; or balance and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Culture of Excellence Behavior Expectations:

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