Scheduling/Billing Specialist Lead (Full Time)

Assists the therapy business services leadership in the operation and organization of the outpatient therapy office areas in addition to assigned scheduling and financial specialist duties.

Responsibilities

• Receives patients and visitors, answers telephone, screens calls and callers, and directs them to the appropriate person.
• Creates a welcoming environment for patients and effectively manages positive relationships with referral sources and team members.
• Schedules all patient appointments and coordinates modifications to patient schedules, including reschedules, cancellations, no-shows, and discharges.
• Manages providers' calendars.
• Verifies insurance eligibility and coverage for assigned department(s) via phone or internet.
• Contacts patients prior to their first appointment to counsel them on coverage; if unable to contact beforehand, counsels them upon arrival.
• Documents in account notes in EPIC.
• Gathers billing information for patients with worker’s compensation insurance (employer demographics, responsible billing party, billing address) and coordinates authorization for services.
• Manages and coordinates pre-authorizations for services as needed; sends requested documentation to third-party payers for prior authorization and reauthorization of patient visits.
• Coordinates Price-line requests for cost estimates for patients.
• Counsels patients on payment estimates, prompt pay, and financial assistance applications.
• Reconciles daily patient attendance and charges posted with revenue/usage reports.
• Responds to patient questions regarding their account and ensures solutions to billing complaints or concerns.
• Demonstrates ability to effectively manage details by accurately completing registration/referrals, maintaining medical records, and correcting charges.
• Collects payments as needed.
• Monitors and completes accounts on multiple work queues in EPIC, including referrals and denials.
• Problem-solves, analyzes, and collaborates with patients, therapists, Central Billing Office, Revenue Cycle department, and insurance companies to resolve billing and denial issues, including sending appeals and troubleshooting claim or account errors.
• Documents denials and billing issues to identify processes needing improvement to maximize efficiency and ensure proper payment.
• Creates and modifies documents using word processing and spreadsheet programs.
• Maintains designated filing and record-keeping systems.
• Assists with preparation of reports, graphs, and statistical information.
• Orders supplies for the department.
• Serves as payroll timekeeper for assigned departments.
• Performs other related secretarial and clerical functions as requested.
• Maintains adequate coverage of office personnel at all outpatient clinics on a daily basis.
• Trains office staff to assist in all appropriate duties.
• Keeps current with changes in hospital office procedures and shares updates with scheduling staff.
• Provides leadership, training, and guidance to office staff.
• Ensures accurate daily and monthly billing.

Qualifications

• High school graduate or equivalent.
• Prior administrative experience in healthcare.
• Fluent in written and spoken English.
• Multicultural sensitivity.
• Basic computer skills in Microsoft Office and Outlook.
• Customer/patient-focused.
• Critical thinking skills using independent judgment in decision-making.
• High organizational skills and ability to multitask.
• Strong attention to detail.
• Ability to use standard office equipment.

Benefits

• Paid time off and parental leave.
• 401K matching and employee recognition program.
• Dental and health insurance.
• Paid holidays, short- and long-term disability.
• Pet insurance.
• Early access to earned wages with Daily Pay.
• Tuition reimbursement.
• Adoption assistance.

Schedule

Full-time, Monday through Friday during the day shift.