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Northeast Georgia Health System · 1 day ago

Accounts Receivable Team Lead - Mon - Fri Days - 100% Remote

United States

Full-time

Remote

Entry, Mid Level

2+ years exp

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. The Account Receivable Billing Team Leader is responsible for overseeing the day-to-day operations of the Accounts Receivable Billing and EDI team, ensuring compliance with policies and securing payments for complicated accounts.

AssociationCommunitiesFitnessHealth Care

Responsibilities

Serve as a back-up collector when A/R staff members are out, or a back log develops to assist in getting the department caught up

Responsible for performing monthly billing audits on each A/R staff member, ensuring proper follow-up and reimbursement

Serve as a lead in collecting and reviewing all patient insurance information needed to complete the billing process, while following through on all billing problems to conclusion

Reviews A/R productivity reports and submit summary to Management and A/R staff members. Monitors adjustment reports to ensure compliance with adjustment policy

Responsible for training of new A/R staff members on the practice management system, as well as ongoing training as needed for other supporting systems

Third party payer denial & delinquent account reconciliation, payer rejections resolved

Maintain current knowledge of third party, federal and state regulations, insurance coverage, rejection codes and billing requirements related to physician billing and follow-up. This is to be accomplished by attending related seminars, research, meeting with insurance reps and reading all memos/payer updates

Ensure secondary billing on accounts with secondary liability; follow-up on any unpaid balances

Provide corrected data and resubmit claims as necessary

Respond to patient and third-party inquiries/complaints regarding patient accounts via telephone, mail or in person

Maintain/improve productive third-party relationships

Ensure that denied visits/services are appealed or processed to be written off if applicable

Work closely with other billing personnel and Practice/Billing Manager in following up on accounts, refunds and reports possible write-offs to Practice/Billing Manager

Review/analyze patient accounts and take needed actions to resolve patient issues by executing adjustments, refunds, etc. from incoming/outgoing telephone calls or mail

Provide the highest-level customer service to patients and other CBO or center staff by following through on phone calls, site questions/concerns and account inquiries. Resolve patient complaints and requests regarding insurance billing and initiate accurate account adjustments

Update demographic and insurance information on patient accounts as needed

Keep others in Central Business Office informed of third-party billing updates, documentation guidelines, and reimbursement/ contract administration

Serve as a liaison with payers, collection agencies and patients by being available to answer questions, handle situations as they occur and meet with insurance reps regularly

Follow all billing problems to conclusion and resubmit insurance claims as required

Ensure the integrity and timeliness of workflow by making sure work is turned in as assigned as well as follow-up on the progress and documentation of account load

Complete all necessary insurance forms (i.e., HCFA 1500) to process the proper billing information in a timely manner as required by all third-party payers

Oversees the submission process of electronic claims using various clearinghouses, including troubleshooting and resolving errors

Performs other duties as assigned by management

Qualification

Accounts Receivable BillingEDI Claims SubmissionPatient Billing KnowledgeMedical TerminologyICD-9/CPT CodingElectronic Billing SystemsCustomer Service SkillsCommunication SkillsProblem Solving Ability

Required

High School Diploma

Two (2) years' experience in physician billing, EDI claims submission, and accounts receivable follow-up

Familiar with various payors claims processes and payment policies

GED Accepted

Thorough knowledge and understanding of patient billing, billing transmission and electronic billing systems, including reimbursement knowledge of Medicare, Blue Cross, United Health Care, Medicaid, commercial insurance and HMO carriers

Knowledge of third party, federal and state regulations, insurance coverage, rejection codes and billing requirements related to physician billing and follow-up

Knowledge of medical terminology and ICD-9/CPT coding

Strong written and oral communication skills including the ability to work with other departments

Ability to interpret third party coverage, patient responsibility and evaluate a patient's financial condition

Knowledge of processes for billing professional services provided in the hospital and office setting

Knowledge of electronic billing systems and EMR's

Ability to work and resolve problems independently and demonstrate task completion

Knowledge of the appeals processes for different payers

Knowledge of the refund processes for different payers