Accts Receivable Team Lead / PA Non Medicare Billing

Position Summary

Responsible for assisting the Accounts Receivable (AR) Follow Up/Denials Supervisor, in the day-to-day operations of the AR Follow Up & Denials Specialist Level 1, Level 2 and Level 3.

Daily Operations consist of monitoring timely and accurate collection of third-party payers, resolving outstanding insurance claims across all Hartford HealthCare hospitals, medical group and homecare. Assuring the organization is complying with all federal/state guidelines, keeps abreast of all regulations and standards to ensure compliance with governmental/regulatory agencies or third-party payers, responsible for Epic quality assurance to ensure high quality and cost-effective products or services are delivered.

Position Responsibilities

• Key Areas of Responsibility
• Assists supervisor and team with timely realization of payment for approximately $550+ million in active inventory and $70 million in denials, assisting with the effective resolution of denials, underpayments and credit balances.
• Supports the supervisor with: Implementing and monitoring meaningful goals and objectives, Tracking trends and results, Improving quality and productivity, Identifying opportunities, Recommending and assisting to implement changes, Documenting and implementing policies and procedures, Oversight and management of individual performance expectations, Coaching and developing Employee and professional development, Training opportunities, Vendor relationships and performance.
• Provides input on decisions that affect workflows effecting timely resolution of insurance claims. Provides support for other ad hoc analyses and projects as needed.
• Effectively and continually communicates with staff, management and customers to facilitate the flow of information. Demonstrates H3W Leadership Behaviors.
• Actively seeks opportunities to model teamwork through collaboration both within and outside the workgroup in support of the organization’s objectives Assumes responsibility for self-improvement in collaboration with superior
• Maintains effective positive customer service, ensuring the needs are met and educating staff on the importance of quality customer service
• Provides training support for colleagues
• Daily Huddle Leader

Working Relationships

• This Job Reports To: AR Follow Up/Denials Supervisor
• Job Title(s) of HHC positions reporting to this Job: Assist AR Follow Up Supervisor and AR Collections Specialists in their efforts to review and resolve issues related to insurance claim denials, no response claims and payment variances including underpayments and overpayments. Provides ongoing support and training to AR Collections Specialists as needed. Participates in the process of interviewing applicants and provides feedback to hiring manager. Assists in the onboarding and training of new AR Collections Specialists.

Qualifications

• Education
• Minimum: High school diploma, GED or equivalent
• Preferred: Associate’s degree in health care administration, business management or finance or equivalent healthcare revenue cycle experience.
• Experience
• Minimum: 4+ years medical billing and/or accounts receivable in a facility or professional healthcare revenue cycle setting.
• Preferred: 4+ year’s medical billing and/or accounts receivables experience in a facility or professional healthcare revenue cycle setting.
• 1-3 years supervisory experience in a facility or professional medical billing and/or accounts receivables setting.
• Licensure, Certification, Registration
• PREFERRED: American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) certification
• Knowledge, Skills And Ability Requirements
• Epic experience and working knowledge of Resolute Hospital and Professional billing modules preferred
• Excellent analytical and problem solving skills
• Excellent communication skills both written and verbal and interpersonal skills
• Knowledge of state and federal regulations as they pertain to billing processes and procedures
• Knowledge of insurance claim processing and third party reimbursement
• Knowledge and detailed understanding of all negotiated agreements
• Demonstrated leadership in establishing and achieving goals
• Ability to communicate effectively both orally and in writing, strong computer and math skills required
• Skill in problem solving in a variety of settings
• Skill in time management and project management
• Ability to work efficiently under pressure
• Ability to operate a computer and related applications such as Word, Excel, PowerPoint, etc.
• Ability to apply appropriate supervisory, management and leadership techniques in an operational setting
• Ability to work independently and take initiative
• Strong leadership skills and ability to motivate direct reports