Team Leader Billing / Follow-up

Job Summary :

To ensure prompt and efficient billing and follow up of all claims in order to receive payment in a timely manner. Is a “working supervisor”, and is willing and able to perform any duty in the billing / follow-up area as the need arises. In performance of these duties, this role is responsible for and includes, but is not limited to the following :

• Responsible for processing billed error and hold claims on a daily basis. Ensures that the hold claims are at an acceptable level. Communicates with the appropriate departments to ensure data is obtained timely in order to file the claim.
• Ensures there is no excessive and / or unjustified amount of backlogged claims in the work area. Maintains a clear understanding of goals set and strives to meet these goals weekly.
• Able to perform manual intervention of claims such as “split bill”, add room charges, or any other procedure necessary to process an account.
• Responsible for filing all claims requiring special documentation. Each claim must be reviewed and submitted / mailed on a daily basis.
• Average quantity and value of accounts worked each day meets standards. Working an account includes for filing, rebilling, appealing and working of insurance claims on the hospital accounts receivables.
• Updates to patient accounts notes are documented with appropriate detail. Adjustment requests are accurately computed and documented.
• Patient account’s tools are being utilized to enhance and expedite collections.
• Work queues used with appropriate work-again dates, billing activities codes, sorts, etc. Carrier web sites are utilized, as well as Medicare DDE.
• Patient account notes reflect the aggressive collection logic necessary for expediting payments.
• Ensures that all staff complete their assigned duties effectively and accurately.
• Effectively handles problems brought up by staff by identifying and finding a solution to the problem.
• Performs all duties expected of a supervisor, including monitoring of staff time and attendance, staff work schedules, mentoring and training, disciplinary conferences, and overall team leadership.
• Reports all issues or concerns regarding the insurance billing area to the appropriate manager. Keeps manager informed and up to date on issues pertaining to the billing area.
• All other duties assigned
• Must be able to demonstrate knowledge and skills to appropriately communicate and interact with the patients, families, and visitors of all age groups while being sensitive to their cultural and religious beliefs.

Performance Expectations :

Qualifications : Education / Skills :

Some college preferred. High school diploma or equivalent required.

Work Experience :

Three years of experience as an insurance biller, preferably in a hospital business office. Extensive knowledge of Medicare, Medicaid, and insurance preferred. One year of supervisory experience is preferred.

Mental Demands :

Oral and written communication skills are important to relate to hospital personnel, patients, and other third parties. Must have basic math skills to perform calculations for insurance analysis and proration. Typing skills preferred. Microsoft Excel experience required.

Work Location :

This position offers both in-office work and telecommuting work from home. Ample workspace will be provided by FGH for office work. Appropriate telecommuting work environment includes but is not limited to :

Acknowledgment of FGH-issued equipment that remains the property of FGH and shall be returned undamaged in the event employment is terminated.

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