Accounts Rec Billing Lead at PIONEERS MEMORIAL HEALTHCARE DISTRICT – Brawley, California

SUMMARY:

Responsible to coordinate and oversee the day-to-day activities of billing, collections, productivity, quality and A/R aging of designated team, with particular hands-on attention to A/R billing and follow-up. A/R categories are Medicare, Medi-Cal and Commercial.

ESSENTIAL FUNCTIONS:

1. Coordinate and oversee day-to-day activities within the designated team to include but not limited to, over-seeing the timely billing and account resolution of all payers in category.
2. Demonstrates a thorough knowledge and understanding of billing and follow-up policies on and on-going basis and answer questions from co-workers when necessary.
3. Practices continuous efficiency/process improvement implements corrective action, monitors and reports findings to the Director of Patient Accounting.
4. Establishes productivity standards for timeliness and productivity of responsible activities.
5. Performs staff job responsibilities as needed. Coordinates respective staff member’s work schedules, whereby assuring adequate coverage, in an effort to carry out day-to-day responsibilities.
6. Performs internal training of new/current employees, as well as cross training current employees whereby assuring coverage of critical job duties to ensure competency level.
7. Manages and identifies inappropriate employee behavior, initiates and monitors corrective actions according to organizational policies and procedures.
8. Keeps informed of all Government, HMO, PPO, Workers Compensation, and third-party payer regulations and procedures affecting the billing, collection, and reimbursement of claims.
9. Provides feedback to Director, Registration Manager, and/or other departments as it relates to quality of work generated by departments and their impact of claim submission and subsequent account resolutions.
10. Acts in the capacity of health information system (Affinity) analyst and troubleshooter, as well as other A/R systems.

OTHER RESPONSIBILITIES:

Other duties as assigned from time to time.

Customer Service.

SUPERVISORY RESPONSIBILITIES:

Billers and collectors part of A/R team.

EDUCATION, KNOWLEDGE, SKILLS, ABILITIES, AND EXPERIENCE:

1. High school diploma and/or equivalency. Three to five years in a healthcare Business Office environment is required; Healthcare, hospital preferred, billing experience is required with knowledge of claims submission and follow-up processes for Third Party Payers, HMO/PPO, Workers Compensation, Medicare, and Medi-Cal. Familiarity with reimbursement structures as it applies to all payers.
2. Mathematical ability is required to review and complete statistical data on various reports; Strong clerical background is required.
3. Experience with on-line terminal equipment and automated systems, including personal computers and adding machines. Ability to prioritize multiple projects; Ability to compile and analyze data.
4. Strong oral, written, and interpersonal communication skills.
5. A full-time employee who can demonstrate that they have the ability to develop positive working relations with all internal and external people they come into contact with.

LICENSES AND CERTIFICATIONS:

Preferred but not required- Certified Revenue Cycle Specialist (CRCS) Certification.

AGE OF POPULATION SERVED:

Newborn  Infant/Pediatric  Adolescent  Adult  Geriatric  All  No Patient Care X

PHYSICAL REQUIREMENTS:

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.