N00260 – Billing Team Leader – Lab

Position Overview: The Lab Billing Team Leader is responsible for a variety of duties including the daily oversight of Non-Client Billing, providing feedback on accounts receivable issues to the Manager of Lab Revenue Cycle and the Senior Director of Lab Revenue Cycle. Leads the Lab Billing Team in all aspects of revenue cycle including, but not limited to, submitting claims, billing follow-up, self-pay collections, payment posting, and answering any consumer questions or concerns.

Specific Responsibilities:

• Directly manages the Lab Billing Team.
• Provides management, guidance and training to staff in daily operations.
• Motivates staff and organizes day to day activity of department.
• Ensures productivity standards are met and work distribution is monitored and adjusted to meet demand.
• Understands and ensures compliance for regulatory, accreditation and system process.
• Alerts the Manager of Lab Revenue Cycle regarding any anomalies with the integrity of the billing database.
• Conducts both weekly standup and monthly staff meetings. Prepares agendas and forwards meeting notes to Manager of Lab Revenue Cycle.
• Reviews monthly and weekly accounts receivable dashboards. Identifies opportunities for improvement and develops plan to implement necessary changes to meet performance expectations.
• Reviews accounts receivable on at least a monthly basis to ensure accounts receivable is within established standards.
• Prepares and submits clean claims to various insurance companies or federal funded programs either electronically or by paper.
• Manages unbilled claims; research and resolve issues as appropriate.
• Manages credit and adjustment reports.
• Navigates through 3^rd party payer rules and regulations.
• Maintains current knowledge of payer regulations.
• Assists with maintaining accounts receivable days within designated goal.
• Performs the correct revenue cycle process (i.e. billing or payment posting functions) to adjudicate claim within payers timely filing guidelines.
• Manages rejections from clearinghouse.
• Responsible for providing effective and accurate processing and posting of insurance payments; both manually and/or electronically.
• Resolves discrepancies in payment allowances and ensures appropriate payer compliance according to negotiated contracts and terms.
• Performs office related support tasks, clerical duties and/or general office duties which may include creating reports, typing, filing, faxing, answering telephones, taking messages, and making copies.
• Generates reports and takes actions to report on Key Performance Indicators such as clean claim rate, days in accounts receivable, bad debt percentage, etc.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines and regulations.
• Demonstrates attention to detail, initiative, and judgment.
• Exhibits poise, tact, and compassion dealing with patients
• Performs other duties and special projects as assigned.

Education and Experience:

• High school diploma or equivalent GED; Associates degree preferred.
• 4+ years’ experience in a position meeting and communicating with the public.
• 4+ years of billing, payment posting, or A/R experience in a healthcare setting
• At least one year of supervisory experience of at least ten employees
• Proficient in Microsoft Office Suite, especially Excel

Competencies:

Customer Service: Demonstrates concern for meeting internal and external customers’ needs in a manner that provides satisfaction for the customer within the resources that can be made available.

Integrity: Upholds personal and professional ethics and values, considering the values of RCA and respecting the culture, beliefs and abilities of individuals.

Ability to effectively deal with difficult people: the ability to respond to difficult customer behavior with diplomacy and tact including defusing anger, creating rapport an influencing behavior.

Work Environment: May work in a variety of environments including professional offices, clinics, hospitals, or out-patient facilities. They spend much of their time on their feet, actively working with patients.

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

Travel: Travel is primarily local during the business day, although some out-of-the-area and overnight travel may be expected