RBO LEAD PATIENT ACCOUNT REP Full Time Days in Knoxville, Tennessee at Dolly Parton Children's Hospital

Position Title: RBO LEAD PATIENT ACCOUNT REP Full Time Days

Location: Hybrid

Req ID: JR103382

Job Type: Full time
Description: BASIC PURPOSE OF THE JOB

To ensure staff and properly trained and following proper office policies and procedures for billing and collections for all offices.

REPORTS TO

• Director - Business Office

JOB REQUIREMENTS

Supervisory Responsibilities: YES

Minimum Education: High School Diploma/GED

License/Certification Required: None

Minimum Work Experience: Hospital billing and collection experience preferred. Hospital or insurance contract experience preferred.

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES

• Excellent customer service skills and ability to work well with a team required. Familiar with rules and regulations of CMS and other third party payers to ensure proper set up of contract and works with billing staff to ensure clean claims on first time submission. Ability to work with insurance companies to ensure timely payment of claims and address payment variances. Able to lead and train staff for optimum performance of team. Work with Contract team at time of contract renewals to address contract compliance issues. Comfortable in working with PC, file downloads, balancing skills. Able to problem solve. Accuracy of posting key to proper follow up of patient accounts

DUTIES AND RESPONSIBILITIES

• Processes all bills on the day they are received: If unable to process, creates a note posted in the system explaining delay. Reports billing problems to team leader to ensure timely correction of issues. When in doubt, references policies and procedures or consults team leader. Stays current with specific insurance company requirements to ensure proper submission of first claim (clean claim). Requests new billing edits/process changes when needed to ensure clean claims.
• Follows up on accounts per departmental guidelines. Maintains acceptable AR levels for areas of responsibility. Works credits in a timely manner.
• Works all insurance rejections in a timely manner: Worked the day they are received. Offers solutions for repeat issues for long-term solution. Appeals denials as needed. Communicates electronically with payer when possible to ensure proper audit trail to dispute timely filing, issues with proper response, etc.
• Works effectively with office managers/teams to ensure a seamless process flow between departments and the revenue cycle: Notifies team lead of problems and trends by office to help solve issues. Notifies team lead of exception behaviors so we can reward those efforts
• Creates a team environment to problem-solve issues with all teams. Creates notes that are of a nature they can be shared with the customer or appropriate for use in a legal document. Documents accounts properly. All interactions require a note unless there is a financial transaction that speaks for itself, posting payment, adjustment, etc.
• Attends all required safety training and CBL requirements: Attends all educational programs as needed. Practices safe lifting and body mechanic procedures. Maintains a safe and clean work area. Can answer questions related to training and/or knows where to find information for all safety training
• Provides teachable moments for all staff and coworkers. Captures and e-mails screen prints to proper managers for follow-up and additional training. Specific examples will help assist in that process.
• Provides daily leadership to team: Reassigns work as needed to meet the demands of the day. Maintains team schedule and follows the established process with manager to ensure proper coding of timecards in Kronos. Assists staff as needed. Assists/complets Annual Performance Reviews before date due out of respect for staff.
• Leads by example: Serves as a role model for all staff in how work is completed; how to treat co-workers and families. Privately discusses with team mates when they see issues relating to showing respect and dignity to any of our customers or co-workers. Ensures privacy for staff when addressing work related issues or concerns
• Works with team leaders/managers to strengthen processes and problem-solve issues. Manages all activities to ensure quality services are provided in an efficient and effective manner as observed by Manager/Director. Works to improve quality of services provided by the department.
• Maintains professional composure and confidence during stressful situations
• Maintains confidentiality of all hospital and patient information at all times as observed by management and peers: Will not discuss any patient information in public areas. Will not discuss any patient with friends, family who may call to ask about a child who has been here. Will only discuss other accounts with staff on a need to know basis to ensure payment of the claim or resolution of a problem. Only shares minimal information needed by others to perform the job. Will not view accounts of friends, family mambers unless requested by the person responsible for the bill. Will hand off to another team member when working an account that could be considered a breach of privacy by a neighbor, child, family members' child, etc.
• Handles patient/family complaints in a confidential, timely, and professional manner: Calls are answered timely and families are given a response within 24 hours as observed by management. Takes initiative on the call to settle any disputes while on the call when possible. Always ends conversation with family after a complain or dispute with "is there anything else I cna do for you today" as observed by management
• Works with office managers/team leads to ensure best practice is followed.
• Manages departmental human resources according to organization-wide policies and procedures to ensure quality services and promote positive employee relations: Establishes, maintains, interprets, and evaluates department policies and procedures that reflect the organization's standards. Employee performance appraisals are completed thoroughly and submitted on time. Documents incidents, problems, compliements, etc. in a timely and thorough manner. Follows HR policies to implement progressive discipline and corrective action, when necessary. Maintains effective and appropriate staffing by monitoring employee turnover, overtime, and absenteeism.
• Creates training as needed for team/department to ensure current needs are met and encourages staff development and growth. Stays abreast of all third party procedures and communicates with staff and departments when changes are identified. Continuously displays a "can do" attitude within the department and across department lines to contribute to the overall focus on service excellence at the hospital.
• Identifies problems, offers solutions, and communicates with Management as needed: Recognizes problems and works with team leader to come up with long-term solutions to solve the problems, as observed by management. Sees problems as an opportunity to problem-solve and improve work for team as observed by management. Talks openly with management to make aware of process issues and suggest training opportunities, process improvements for the department/team.
• Manages departmental resources effectively and proactively initiates cost-saving measures through process improvements and vendor selection. Utilizes hospital resources and time respectfully and accountably. Only requests what is needed to do the job.
• Works as efficiently as possible to ensure best use of time in account, short staffed for the day, major problems with billing, etc.
• Works to ensure timely billing and follow-up of claims to ensure we collect net dollars due on all accounts.

PHYSICAL REQUIREMENTS

• Note: Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position.
• Light lifting, pushing and pulling is required for 10-20 lbs occasionally and frequent moving of objects of less than 10 lbs is required. Frequent sitting with some walking, standing, squatting, bending and reaching is required. Keyboard/computer use and/or repetitive motions may be required.

Come work where you can make a difference everyday.

About Us:

At Dolly Parton Children’s Hospital, care is at the CORE of who we are. We are comprised of team members who live out our core values of Compassion, Ownership, Respect, and Excellence. We support each other by fostering a culture of team engagement that creates moments that matter – every interaction, every time.

• Compassion – We imagine what others are going through, work to alleviate suffering, and create joy whenever possible.

• Ownership – We take pride in our work, act with integrity, and feel personal responsibility for achieving our mission.

• Respect – We listen, understand, and communicate openly and politely. We recognize our diverse strengths.

• Excellence – We set high standards for performance in delivering the safest patient care. We give extraordinary and meaningful experiences to our patients, their families, team members, and the community we serve.