Remote - Lead PFS Medical Billing Specialist

About the role

The PFS Medical Billing Specialist Lead's general responsibilities include but are not limited to: ... (the paragraph). Actually that paragraph is long; we could keep as prose. But we also have a separate "Responsibilities" heading later with more detailed responsibilities. To avoid duplication, we could merge? The instruction: Preserve ALL substantive information; do NOT invent or summarize away detail. So we need to include all responsibilities. The About the role paragraph is a subset of responsibilities; we could keep it as part of About the role, but then Responsibilities section would duplicate. Better to treat About the role as a brief overview (maybe the first sentence) and Responsibilities as detailed list. However the first paragraph is quite detailed; we could keep it as About the role and then Responsibilities section could contain the rest (the bullet list after "Responsibilities"). But that would split responsibilities; still all info preserved. Let's extract: First paragraph after "Job Description": "The PFS Medical Billing Specialist Lead's general responsibilities include but are not limited to: Performs as a proxy for the department manager as needed Participates and coordinates productivity and quality program standards as needed Participates and coordinates payer meetings as needed Performs as a subject matter expert to caregivers for account resolutions Ensures and stays up to date on hospital and/or clinic compliance with all state and federal regulations and reports suspected compliance issues to the department manager Plans, coordinates, and implements on boarding efforts for new caregivers Organizes and implements initial and on-going staff training and education in collaboration with the department leader as needed to drive departmental performance. This includes but is not limited to: One-on-One training sessions, group training sessions, and educational meetings for new and updated payer guidelines. Assists departmental leaders in establishing, implementing and verifying adherence to controls that maintain appropriate billing and reimbursement practices Acts as a mentor to any caregiver within the organization Works regularly with all revenue cycle departments to analyze and resolve accounts Ensure month-end reconciliation reports are completed accurately each month Assists the department manager in compiling reports as needed Accurately bill claims Ensure timely filing deadlines are met for various payers Adequately bill claims per compliance and payer guidelines Collaborate with various areas of revenue cycle and the organization to ensure accurate and timely billing of claims Stay current on compliance and payer policies and share information with other caregivers within the organization Act as a mentor to caregivers in the Medical Billing Specialist I and II roles Participates in team activities, trainings and/or educational meetings Identifies trends and root causes to issues Escalates trends with solution proposals Proactively researches and understands payer issues Collaborates with payer representatives regarding compliant claim submissions Assists with special projects, audits and reports Provides extensive analysis and research for complex claim errors and rejections Identifies solutions to complex claim errors and rejections Projects enthusiasm and energy in all efforts" Then later there is a "Responsibilities" heading with more bullet-like sentences: "Collaborates with manager to map existing processes, facilitates process improvement, assists with identifying and creating approaches to implement change and/or updates and assists with oversight into development plans and execution of plans to improve standards and departmental processes.Serves as “project manager” on projects such as PFS initiatives and on-going staff training/education including but not limited to: one-on-one and group caregiver training meetings and educational group meetings.Designs, develops, configures, and implements onboarding efforts for new caregivers and ongoing caregiver training/education for existing caregivers.Performs as proxy for manager, performs quality reviews for team and acts as a mentor to the Medical Billing Team(s).Provides complex review and analysis of claims including researching payer guidelines, collaborating with provider representatives and departmental leaders as necessary in establishing process improvements.Creates and maintains process and workflow documents to aid in continuous training for caregiversActs as a first escalation tier for caregiver issues and concerns and will work to resolve/escalate appropriately with manager.Knowledgeable in both hospital and professional billing compliance, payor guidelines, and system functionality.Research and resolve complex billing questions and discrepancies including familiarity with regulatory guidelines. Proactively researches and understands payer policies and contracts and accurately provides updated information to the PFS teams and Leadership.Collaborates with other departments within revenue cycle to resolve billing and compliance issues or concerns.Attend and/or lead appropriate PFS meetings to capture follow-up items and coordinates with appropriate leadership for resolutionDevelops and maintains continuity with internal and external relationships for multiple PFS and hospital/clinic departments/provider representatives to ensure support and participation in PFS initiatives.Previous leadership experience highly preferredPerforms all other duties as assigned by departmental leadersWorks regularly with other revenue cycle departments to analyze and resolve accounts and/or systematic issues.Works with revenue cycle leadership to ensure that billers are following the correct steps and processes when working accounts.Dependable in both production and attendance" We could combine both sets into one Responsibilities list to avoid duplication. But we must preserve all info; combining is fine as long as we don't lose any. We'll create a single Responsibilities

with all items from both paragraphs. We need to split into sensible list items. Could just take each sentence separated by period. But we can keep as is but separate by
• for each distinct responsibility. Might be many; but okay. Simplify: We'll create a list where each line starts after a period and before next period. However that's tedious. Perhaps we can keep the paragraphs as prose inside

  under Responsibilities, but instruction says use

  • for any list of duties/requirements/benefits. The responsibilities are a list of duties, so we should use
    • . We'll break by sentences. Let's extract sentences from first paragraph: 1. Performs as a proxy for the department manager as needed 2. Participates and coordinates productivity and quality program standards as needed 3. Participates and coordinates payer meetings as needed 4. Performs as a subject matter expert to caregivers for account resolutions 5. Ensures and stays up to date on hospital and/or clinic compliance with all state and federal regulations and reports suspected compliance issues to the department manager 6. Plans, coordinates, and implements on boarding efforts for new caregivers 7. Organizes and implements initial and on-going staff training and education in collaboration with the department leader as needed to drive departmental performance. This includes but is not limited to: One-on-One training sessions, group training sessions, and educational meetings for new and updated payer guidelines. 8. Assists departmental leaders in establishing, implementing and verifying adherence to controls that maintain appropriate billing and reimbursement practices 9. Acts as a mentor to any caregiver within the organization 10. Works regularly with all revenue cycle departments to analyze and resolve accounts 11. Ensure month-end reconciliation reports are completed accurately each month 12. Assists the department manager in compiling reports as needed 13. Accurately bill claims 14. Ensure timely filing deadlines are met for various payers 15. Adequately bill claims per compliance and payer guidelines 16. Collaborate with various areas of revenue cycle and the organization to ensure accurate and timely billing of claims 17. Stay current on compliance and payer policies and share information with other caregivers within the organization 18. Act as a mentor to caregivers in the Medical Billing Specialist I and II roles 19. Participates in team activities, trainings and/or educational meetings 20. Identifies trends and root causes to issues 21. Escalates trends with solution proposals 22. Proactively researches and understands payer issues 23. Collaborates with payer representatives regarding compliant claim submissions 24. Assists with special projects, audits and reports 25. Provides extensive analysis and research for complex claim errors and rejections 26. Identifies solutions to complex claim errors and rejections 27. Projects enthusiasm and energy in all efforts Now second paragraph sentences (split by period): 1. Collaborates with manager to map existing processes, facilitates process improvement, assists with identifying and creating approaches to implement change and/or updates and assists with oversight into development plans and execution of plans to improve standards and departmental processes 2. Serves as “project manager” on projects such as PFS initiatives and on-going staff training/education including but not limited to: one-on-one and group caregiver training meetings and educational group meetings 3. Designs, develops, configures, and implements onboarding efforts for new caregivers and ongoing caregiver training/education for existing caregivers 4. Performs as proxy for manager, performs quality reviews for team and acts as a mentor to the Medical Billing Team(s) 5. Provides complex review and analysis of claims including researching payer guidelines, collaborating with provider representatives and departmental leaders as necessary in establishing process improvements 6. Creates and maintains process and workflow documents to aid in continuous training for caregivers 7. Acts as a first escalation tier for caregiver issues and concerns and will work to resolve/escalate appropriately with manager 8. Knowledgeable in both hospital and professional billing compliance, payor guidelines, and system functionality 9. Research and resolve complex billing questions and discrepancies including familiarity with regulatory guidelines 10. Proactively researches and understands payer policies and contracts and accurately provides updated information to the PFS teams and Leadership 11. Collaborates with other departments within revenue cycle to resolve billing and compliance issues or concerns 12. Attend and/or lead appropriate PFS meetings to capture follow-up items and coordinates with appropriate leadership for resolution 13. Develops and maintains continuity with internal and external relationships for multiple PFS and hospital/clinic departments/provider representatives to ensure support and participation in PFS initiatives 14. Previous leadership experience highly preferred 15. Performs all other duties as assigned by departmental leaders 16. Works regularly with other revenue cycle departments to analyze and resolve accounts and/or systematic issues 17. Works with revenue cycle leadership to ensure that billers are following the correct steps and processes when working accounts 18. Dependable in both production and attendance We can combine both lists, removing duplicates (some overlap like "Performs as proxy for manager" etc). We'll keep all. Now Education and Work Experience: Education: