JobDescription: Billing Team Lead
Reports to:Revenue Cycle Manager
Job purpose:
We are apediatric non-profit organization seeking a billing team lead to join our professionalteam. The billing team lead will manage all matters and communications relative toinsurance claims on behalf of Texas Hearing Institute (THI). Reporting to Revenue Cycle Manager, the billing teamlead is responsible for all staff scheduling on site for scheduling needs,customer service with insurance or patients, process claims and payments,minimize bad debt, improve cash flow and manage the overall health ofreceivables. Work with leadership to improve and automate workflows.
PositionInformation:
Hours Weekly: 40
Monday - Thursday 7:30-5:30
Friday - 8:00- 3:00
Starting: Determined by experience
FLSA Status: Non-exempt
Benefits:
Health Insurance
Dental Insurance
Life Insurance
Long Term DisabilityInsurance
403(b) Retirement Plan
12 Paid Holidays
21 Paid Time off Days
Responsibilities:
• Assists with workflowof the Revenue Cycle Staff including Billing Specialists and Billing Associates personnel
• Identify revenue cycleproblems help with implement solutions with Revenue Cycle for improvement
• Maintainsopen communication with Revenue Cycle Manager, regarding contractual issues,denials management and claims assessment
• Assistwith scheduling needs of calls out / PTO
• Assistwith Audits for clinics
• Assistwith overall revenue cycle including but not limited to electronic insuranceverification, charge entry, claim submission, claims processing, claimsrejections and resolution, assist of appeals, proper charting and documentationrequirements, Charge entry- including proper coding, acceptance and turnaroundtime by carrier, Payment Posting and contractual variance monitoring, patientAR management, invoices, follow up calls and letters and 3rd party AR turnover time
• Assistwith documentation on issues with resolution and shares with team members toimprove team knowledge of Revenue Cycle
• Teamand Individual Trainings of Revenue Cycle that are relevant andnecessary for the continuous development of the technical competencies of theteam
• Assistadheres to and implements the philosophy of "hiring the best fit" and ensuresthat prospective Employees' personal values are aligned with our core values.
• Allcommunications and relevant information pertaining to the team are cascaded tothe proper channels within team in particular, and organization in general
• Assistin analyze billing and accounts receivable trends and report on progress,results and conclusions reached regarding:
• Timelybilling of services
• Collectionof services billed
• Agingof outstanding accounts receivable
• Unbillableservices
• Writeoff or adjustment resulting from payor denials or rejections on approval frommanagement
• Staysfocused on maximizing revenue and reducing contractual allowances/ discountsMWS and other (grants) write offs at all times
• Filesall THI claims, Files all THI appeals and corrected claims as needed
• Handlesall communication with insurance/ Medicaid provider relations re: underpaymentsand /Or denials through to final resolutions
• Entersand post all service -related (program) payments into IMS software
• Regularlyreviews all clients accounts and keeps them clean, including notifying clientsof balances due, issuing check request for refunds due, or making necessaryadjusting entries, THIS STEP INCLUDES "COMPLETING" CLAIMS IN IMS ADJUDICATIONSO THAT THE CLAIMS ARE PROPERLY & TIMELY CLOSED
• AssistDirector of Finance (DOF) in accounts Receivable (A/R) management, linksbetween IMS software and QuickBooks (QB), including email directives to DOFwith specific instructions re: clearing client accounts
• AssistDOF with awareness of Insurance/ Medicaid policy and / or contractual changesand notifies management and/ or program directors as changes occurs
• Assistwith credentialing process
OtherResponsibilities:
• Actsas backup to THI Verification Specialist, Front desk billing associate,Authorizations and check out in their absence or as needed
Education andExperience Requirements:
• Highschool diploma
• Musthave three-plus years of claims (Insurance billing) experience
Specific Skills:
• Knowledgeand acquired usage of Microsoft standard programs; in particular, MicrosoftWord and Excel
• Goodcommunication skills, particularly with inter-departmental communications
Key Competencies:
• Verbaland written communication skills
• Professionalpersonal presentation
• StandardPC usage
• OfficeOrganization
• Reliability
Basic Competencies:
• Internet-using the internet for filing claims, gathering information, and communicating
• Spreadsheets-knowledge and ability to create, modify and electronically transmit
• Emailand fax machine knowledge and familiarity
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