Revenue Cycle Team Lead

1 week ago

Orlando, United States Vital Care Infusion Services Full time
Job Summary:

Perform functions to plan for and train the Reimbursement Specialist position, involving initial intake, billing, and collections requirements. Will cultivate an environment of outstanding customer service as the voice of the company in all interactions with franchise partners, payers, and patients.
Duties/Responsibilities:
  • Train team in the processing of new patient referrals, insurance benefits investigation and verifications, prior authorizations, billing, and collections.
  • First level of review for items being escalated to outside departments as well as other Revenue Cycle Leadership.
  • Review A/R adjustment forms to the max level allowed.
  • Assist in reviewing payer refunds and/or cost refunds when requested
  • Track distribution of workloads and conduct ongoing needs assessments to identify staffing opportunities and report those to the Revenue Cycle Supervisor.
  • Serve as primary escalation agent for the team to resolve any franchise partner or patient complaints. Report complaints to the Revenue Cycle Supervisor to provide continuous feedback to the Reimbursement Specialist.
  • Cultivate an environment of customer service orientation through training and mentoring staff in customer service and collection techniques.
  • Assisting posting department with missing explanation of benefits on time to ensure properly reconciled revenue.
  • Monitor team activities and work with Reimbursement Specialist to provide guidance, training, and improved skills involved in patient insurance billing, collections, benefits investigation, and insurance authorizations.
  • Monitor team results to evaluate compliance with quality and productivity expectations and identify opportunities for improving results.
  • Work alongside Revenue Cycle Supervisor to actively identify payer issues along with process analysis to ensure effective intake/billing/collection efforts.
  • Review denial trends to implement training and clean claim turnaround time.
  • Evaluate performance and provide counseling, cross-training, and coaching to associates. Maintain mutually respectful employer relations.
  • Perform other related duties as assigned.
Required Skills/Abilities:
  • Highly effective communicator with superior listening, understanding, speaking, and writing skills.
  • Solid knowledge of business and ability to analyze data to identify actions to be taken.
  • Lead by example and strong team-building skills, with the ability to influence and lead, teach, train, counsel, and coach to accomplish organizational goals.
  • Ability to identify training requirements and develop and implement training models to improve results.
  • Demonstrated knowledge of current pharmacy applications and MS Office software including strong Excel proficiency.
  • Strong customer service and leadership skills to develop a customer-centric culture and instill ownership of the customer/patient experience. Ability to foster care and compassion for the patients while also instilling price to exceed performance objectives.
  • Ability to work collaboratively across functional teams and manage projects.
  • Analytical skills and business acumen demonstrated through proven problem solving and the ability to exercise solid professional judgment in analyzing business issues and exploring options for resolution.
Education and Experience:
  • High School Diploma or equivalent is required.
  • 2-3 years of experience is required in an infusion setting.
  • Working knowledge of all Vital Care systems including CareTend, and the RCM Portal.
  • Knowledge of Payer Compliance.

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