Under minimal supervision this position will serve as a resource for the revenue cycle staff in areas including but not limited to manual charge entry, payor guidelines, payment posting and AR patient and Insurance collections. This position will work closely with the revenue cycle supervisor and management team in areas of workflow and day-to-day operations throughout the revenue cycle team. The Sr. medical billing specialist team lead is also responsible for assisting in overseeing workflows and processes as well as continuously looking for improvements in the revenue cycle. Supports the Revenue Cycle Supervisor and management team responds positively to special projects and assigned responsibilities. Responsible for training any new hires in the various systems and workflows. The Sr. Medical Billing Specialist Lead will be responsible to work adhoc projects for the various teams and serve as subject matter expert in regards to processes. Perform other duties as assigned.
Will assist in identifying and reporting issues working with the management team to help minimize re-work and address front-end process issues.
Job Knowledge, Skills, and Competencies
Diversity – Demonstrates ability to work with a diverse group of people in a manner that enables them to reach their full potential, in pursuit of organizational objectives.
Technology & Equipment Skills – Maintains knowledge of technology, tools, equipment and other devices in work area. Demonstrates competence in technology skills required for the role, as well as ability to learn and master new skills. For clinical position this includes equipment and devices pertinent to treatment, procedures and practice.
Interpersonal Skills - Listens to and understands what others are saying. Establishes effective working relationships with others, contributing to a climate of mutual respect and cooperation. Uses language to the situation. Demonstrates sensitivity and tact, understanding own effect on the motivation, attitudes and actions of others. Makes favorable first impressions.
Job Knowledge – Demonstrates full knowledge and understanding of concepts and procedures needed to be successful in the role, including knowledge of applicable department, organization and external rules and regulations impacting day to day processes. For clinical positions, this includes clinical procedures required by department and unit, as demonstrated by unit-based competency testing.
Oral/Written Communication - Ability to speak and write effectively, demonstrates fundamental command of language, communicates well using all mediums.
Travel – Position may require local travel between various Organization locations
Organization Behavioral Competencies
Demonstrates honest and ethical behavior. Takes responsibility for both words and actions. Acts with integrity. Maintains patient confidentiality.
Uses resources, equipment and finances appropriately. Demonstrates the functional and technical skills to do the job effectively. Willing and actively shares his/her knowledge with others. Accepts changes and adapts to new situations and responsibilities.
Delivers superior customer service consistent with the Hoag Experience. Displays a professional image. Demonstrates tact, diplomacy and understanding when dealing with difficult situations. Listens and asks questions to understand patient and customer needs. Builds relationships with internal customers and employees. Admits mistakes and takes service recovery to steps to ensure any issues or problems are quickly addressed. Ensures that all information and services provided are safe, accurate, and available in a timely manner and meet regulatory requirements.
Brings forth creative ideas (one’s own or others) to address patient, physician, customer, and community needs. Looks for creative or new ways to improve efficiencies and reduce costs. Adopts new processes, techniques and methods. Stays current with technologies and advances in his/her area, department and/or field.
Education and Experience
High School Diploma or equivalent, 4+ years of experience in in the healthcare field of revenue cycle and medical professional billing High School diploma or higher, Computer knowledge, Knowledge of EHR systems billing practice management systems, Excel, Office, Word, knowledge of ICD-10 codes, CPT codes, HCPCs and HIPPA. Comprehensive knowledge in registration, revenue cycle practices, self-pay collections, insurance billing and payer regulations. Effective communicator, critical thinking skills, and attention detail.
Proficient in Microsoft Word, Excel, Typing/Data Entry
Preferred: Certified coder is preferred. Experience with billing and collections for providers in a multi-specialty setting