MedStar Health Looking for Team Leader – Account Resolution Patient Accounting Full Time

Ready for the next step in your Patient Accounting career?

MedStar Health Patient Financial Services team has an opening for a TEAM LEADER to join our Account Resolution Division (ARD).
The ARD Team is responsible for handling all Medicare Exhaust Claims, COB denials; and High dollar accounts exceeding $100K account charge at the time of billing for Maryland facilities and $500K reimbursement for DC facilities.

Full time, HYBRID schedule, working 4 days a week remotely and only 1 day in the office. Position does require on-site training (up to the first 90 days of employment) in our business office located in Nottingham, Maryland.

Job Description – Provides guidance and assists staff with review and analysis of various reports in assigned area. In cooperation with Supervisor, identifies and analyzes errors to determine action needed for performance improvement. In conjunction with level II Insurance Specialists, assists in researching and addressing administrative customer service issues. Works with all team members to resolve multiple primary and secondary billing, collection, customer service issues with payers and patients.

Education

• High School Diploma or equivalent required
• Associate’s degree in healthcare preferred
• courses in Accounting, Finance and Healthcare Administration preferred
• 1 year experience in patient accounting or in a hospital-based department (systems, billing, medical records, registration, finance). Knowledge of medical terminology and payer billing preferred; leadership experience preferred.
• One of the following certifications must be obtained within 1 year of hire: Certified Revenue Cycle Specialist – CRCSI or Certified Revenue Cycle Prof-Instit – CRCP-I or Certified Revenue Cycle Executive – CRCE-I. Knowledge, Skills, and Abilities
  • Detailed working knowledge and demonstrated proficiency in the major (Medicare, Medicaid and Blue Cross) payer’s application billing and/or collection process, with particular focus on billing specifications and contractual arrangements and/or multiple payer’s insurance verification and pre-certification guidelines.
  • Ability to resolve complex payer issues to completion, training individuals in the billing and collection processes.
  • Excellent communication and interpersonal skills.
  • Excellent organizational skills to manage multiple tasks in a timely manner.
  • Proficient use of hospital registration and/or billing systems, and Microsoft Word and Excel software applications.
  • Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations.
  • Assists with the daily audit and review of reports to ensure that verification completed. May monitor the error tracking and other statistical reporting systems, communicates to supervisor any trends or problem areas. Investigates, monitors, and consults with supervisor and makes recommendations to address untimely follow-up of accounts.
  • Assists with the daily/weekly/monthly audit of accounts to ensure that accounts meet department standards. Makes recommendations to supervisor to improve the effectiveness of verification efforts, reporting any problems or issues with the process.
  • Assists with review and analysis. Maintains ongoing knowledge of specified forms including state required forms and filing requirements. Communicates problems and issues relative to eligibility conversion to appropriate parties. Acts as a liaison between staff, agency and state to resolve issues.
  • Reviews daily reports to insure completion of verification process and readiness of all accounts for and ensuring a standard turnaround time of scheduled services and based on the payer specific requirements for all unscheduled services. Reviews accounts to determine action required, utilizes all resources and documentation.
  • Assists the supervisor with the development of financial, operational, customer service and productivity targets. Assists with selection, training and orienting of department staff. Assists with compiling and maintaining an updated training manual. Provides training to staff including training team members in the specific work applications and computer Systems used for department.
  • May assist with the formal performance reviews and provides feedback to Manager in accordance. Provides timely and appropriate verbal counseling of staff when they deviate from department standards; in conjunction with Manager, assists in the development of measures to improve performance.
  • May complete timecards and maintains attendance records. Coaches and counsels staff. Initiates or makes recommendations to the supervisor for personnel actions (terminations, suspension, evaluations, interviewing, etc.).A May conduct staff meetings on a regular basis. Keeps staff informed via in service meetings and memorandums.
  • Identifies and evaluates staff productivity and base workload assignments, in conjunction with Supervisor, to determine that appropriate allocation of resources, standards and staff performance is optimized.
  • May supervises the day-to-day activities of the assigned staff to accomplish the established monthly and quarterly financial and productivity goals. Establishes priorities, schedules, distributes daily workload and reassigns tasks as necessary.
  • May be accountable for securing information over the phone from the patient or insurance company including pre-collection and preregistration on accounts. Monitors the telecommunications system by measuring voice mail messages, voice mail abandonment, duration of calls taken per representative and duration that each patient is held in queue, etc.
  • Participates in multidisciplinary quality and service improvement teams. Participates in meetings and on committees and represents the department and hospital in community outreach efforts.
  • Researches and analyzes complex and escalated accounts to identify and complete appropriate steps needed for resolution including, but not limited to, the research and resolution of Medicare Exhaust, Coordination of Benefit conflicts, Recovery Audits, and MSP Verification. Recognizes, documents and communicates account and payer trends. Works in collaboration with all teams, payers and patients, utilizing resources to resolve multiple primary and secondary billing, collections, and customer service issues.
  • Maintains daily performance benchmarks pertaining to follow-up. Maintains departmental QA standards within standard error rate.
  • Processes and completes the daily billing of paper claims including timely communication back to the Billing Team as appropriate.