Lead Payment Specialist WMCG

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift

Day (United States of America)

Job Summary:

Payment posting functions under the direction of the Cash Application Supervisor. Supports the overall functions of Patient Financial Services department and Revenue Cycle division. The Cash Applications Team Lead ensures that all posting staff are assigned daily work, reviews and reports productivity, and quality assurance protocol is followed and communicated to the team and leadership. This position provides leadership and direction for all hospital and guarantor payment posting functions to ensure financial viability. These functions include tracking and reporting of electronic payment files coinciding with bank deposit validations, performing and reporting of weekly Quality Assurance, payment research, Epic WQ assignments, maintaining daily cash reporting to achieve the monthly cash posting goals, and team member training. Management skills are required in the daily operations of the assigned area. It is imperative to maintain a good working relationship with management, staff, and external contacts. The Cash Applications Team Lead requires the use of independent judgement and decision making; as well as including management, staff, and external contacts such as insurance companies, state and federal agencies, outside accounting firms and auditors, and the bank. This position is responsible for resolving problems and issues, and discussing sensitive and confidential information.

Core Responsibilities and Essential Functions:

Primary Responsibilities

• Transmit required documentation to third-party payors for the purpose of resolving payments
• Ensure all payor contact is fully documented in the appropriate software application
• Monitor payments for accuracy and timeliness, contacting payors to resolve outstanding amounts and reporting ongoing problems and issues to the unit supervisor
• Recommend accounts for contractual or administrative write-off, along with appropriate justification and documentation
• Meet productivity standards, targets, error ratios, and reporting requirements as assigned by the department manager or supervisor
• Provide individual contribution to the overall team effort of achieving the department AR nd posting goal
• Identify opportunities for system and process improvement and submit to management
• Demonstrate proficient use of systems and execution of processes in all areas of responsibilities
• Demonstrate knowledge of HIPAA privacy standards and ensure compliance with system PHI privacy practices
• Follow the WellStar general Policies and Procedures, the Departments Policies and Procedures, and the Emergency Preparedness Procedures
• Follow JCAHO and outside regulatory agencies mandated rules and procedures
• Utilize assigned menus and pathways in the hospital mainframe system and report software application problems to the appropriate supervisor
• Utilize assigned menus and pathways in foreign software applications and report software application problems to the appropriate supervisor
• Utilize assigned computer hardware and report hardware problems to the appropriate supervisor
• Participate in the testing for assigned software applications, including verification of field integrity
• Develop and maintain positive working relationships with third party payers to facilitate the resolution of issues and expedition of payments
• Develop and maintain positive working relationships with third party payers to facilitate the resolution of issues and expedition of payments

Other Lead Functions

• The Cash Applications Team Lead ensures that all posting staff are assigned daily work and all staff productivity reviewed and reported.
• Monthly quality review of payment posters. The findings will be communicated to the staff by the Team Lead or Manager for review and/or correction. A copy will be maintained in the department employee file.
• Training/Assistance Goal: Provide initial and ongoing training for all Payment Department staff. The Lead will provide additional training as needed based on the Quality Assurance Reports. Assist staff with questions and/or problems as a priority to limit any delay in productivity. Measurement: Procedures and job aids will be reviewed with each staff member indicating that a poster has working knowledge and understands each function. The Quality Assurance report will also assist in determining if the staff has been adequately trained.
• Transactions Goal: Insurance deposits (EFT/Lockbox) and Zero EOBs not posted are less than or equal to 1 business day daily and at month end. Measurement: The Daily Deposit Log Report for the month will provide deposit totals daily and at month end.
• Payment research received from payment posters and other departments.
• Cross train staff in payment posting functions (i.e. electronic, lockbox, reports)
• Verify receipt of 835 posting files.
• Assist with payment posting
• Identify payer payment issues with payer provider representatives
• Unposted cash daily and monthly average according to current KPI
• Assist in developing and maintaining policies, procedures, job aids and staff training.
• Perform other duties and responsibilities as assigned

Supervision

• Act as a mentor to Cash Posting Specialists
• Provide guidance to Cash Posting Specialists

Professional Communication

• Maintain confidentiality in matters relating to patient/family.
• Assure patient privacy and confidentiality as appropriate or required.
• Ensure minors have a parent or guardian listed as guarantor as appropriate.
• Interact with patients/families with a variety of developmental and sociocultural backgrounds.
• Provide information to patients and families to reduce anxiety and convey an attitude of acceptance, sensitivity, and caring.
• Maintain professional relationships and convey relevant information to other members of the healthcare team within the facility and any applicable referral agencies.
• Initiate communication with peers about changes and procedures.
• Relay information appropriately over telephone, email, and other communication devices.
• Interact with internal customers including HIM, Revenue Integrity, Patient Access, and the SBO in a professional manner to achieve revenue cycle department AR goals and objectives.

Teamwork

• Assist with special projects as assigned.
• Work closely with other staff, co-workers, peers, and other members of the healthcare team to ensure a positive and effective work environment.
• Report to appropriate personnel regarding assignments, projects, etc.
• Initiate problem solving and conflict resolution skills to foster effective work relationships with peers.
• Report to work on time and as scheduled.

Professional Development

• Attend staff meetings, in-services, and continuing education.
• Assist in the development of indicators, thresholds, study methods, and data collection as assigned.
• Respond to problems/opportunities to improve care/customer service.
• Support involvement in system performance improvement initiatives.
• Participate in and maintain competencies required for the position and specific unit/area(s) of assignment.

Performs other duties as assigned

Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

High school diploma or GED equivalent Required

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

Additional License(s) and Certification(s):
Required Minimum Experience:

Minimum 4 years experience in healthcare automated cash applications Required and

previous supervisory experience Preferred

Required Minimum Skills:

Skill in problem solving in a variety of settings

Skill in motivating and directing the work and activities of staff with the ability to effectively delegate

Skill in technical and professional accounting

Skill in good oral, written, and interpersonal communication, grammar, and spelling

Skill in time management and project management

Strong understanding of 835 Remittance Files functionality

Strong understanding of Clearing House vendor management from a Payment Perspective.

Ability to work cooperatively in a team environment

Ability to set climate for performance at optimum levels

Ability to establish and maintain a cohesive work team

Ability to work efficiently under pressure

Ability to apply appropriate leadership techniques in an operational setting

Ability to work independently and take initiative

Demonstrates a commitment to continuous learning and to operationalize that learning and top operationalize that learning

Ability to willingly accept responsibility and/or delegate responsibility

Ability to deal effectively with constant changes and be a change agent

Ability to deal with difficult people and/or difficult situations effectively

Ability to set priorities and use good judgement for self and staff

Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.

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