Account Rep Ld Follow-up

Job Summary

Supports Hospital Billing Supervisor and provides leadership and direction to the Account Resolution Representatives. Is the primary resource for training of new team members and continued training of current staff. Lead will assist in the coordination and implementation of new procedures and protocols within the department. They will be a resource for escalated insurance issues. The lead may also be required to perform Account Resolution Rep duties in addition to the Lead essential functions.

Essential Functions

• Trains, orients and provides resource support for the assigned follow-up work group, including information related to departmental operations and computerized systems.
• Responsible for set-up and upgrades of computerized systems to include entry, testing and training of staff.
• On a daily basis, reviews the denial, follow-up, credit, and variance work-queue claims volumes to assess follow-up needs and identify shortfalls.
• Maintains current knowledge of managed care payer contracts and third party payer billing/reimbursement policies for all lines of business (Government, HMO and Commercial).
• Maintains a thorough understanding of A/R functions, Department policies and procedures, information systems and business relationships.

Preferred Experience

• 2+ years experience in health care revenue cycle operations including insurance reimbursement procedures and comprehension of insurance EOB’s.
• Pediatric experience a plus.
• Prior Epic experience is strongly preferred.

Preferred Knowledge, Skills and Abilities

• Excellent verbal and written communication skills.
• Bilingual a plus.
• Strong analytical skills and ability to perform non-complex arithmetic calculations when determining contractual allowances.
• Ability to work independently with minimal supervision.
• Ability to demonstrate leadership skills.
• Proficient in Microsoft Office applications and technology skills required to perform duties.

Required for All Jobs

• This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that may be requested in the performance of this job.
• Employment is at-will.
• This document does not create an employment contract, implied or otherwise.
• Full Remote Work Opportunity!
• Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.

Certifications/Licenses

• Professional certification in claims processing through HFMA or AHAAM is a plus.