Billing Team Lead

Job Description: Billing Team Lead

Reports to: Revenue Cycle Manager

Job purpose:

We are a pediatric non-profit organization seeking a billing team lead to join our professional team. The billing team lead will manage all matters and communications relative to insurance claims on behalf of Texas Hearing Institute (THI).  Reporting to Revenue Cycle Manager, the billing team lead is responsible for all staff scheduling on site for scheduling needs, customer service with insurance or patients, process claims and payments, minimize bad debt, improve cash flow and manage the overall health of receivables. Work with leadership to improve and automate workflows.  

Position Information:

Hours Weekly: 40

Monday – Thursday 7:30- 5:30

Friday – 8:00- 3:00

Starting: Determined by experience

FLSA Status: Non-exempt

Benefits:

Health Insurance

Dental Insurance

Life Insurance

Long Term Disability Insurance

403(b) Retirement Plan

12 Paid Holidays

21 Paid Time off Days 

 Responsibilities:  

·         Assists with workflow of the Revenue Cycle Staff including Billing Specialists and Billing Associates personnel

·         Identify revenue cycle problems help with implement solutions with Revenue Cycle for improvement

·         Maintains open communication with Revenue Cycle Manager, regarding contractual issues, denials management and claims assessment

·         Assist with scheduling needs of calls out / PTO

·         Assist with Audits for clinics

·         Assist with overall revenue cycle including but not limited to electronic insurance verification, charge entry, claim submission, claims processing, claims rejections and resolution, assist of appeals, proper charting and documentation requirements, Charge entry– including proper coding, acceptance and turnaround time by carrier, Payment Posting and contractual variance monitoring, patient AR management, invoices, follow up calls and letters and 3rd party AR turnover time

·         Assist with documentation on issues with resolution and shares with team members to improve team knowledge of Revenue Cycle

·         Team and Individual Trainings of Revenue Cycle that are relevant and necessary for the continuous development of the technical competencies of the team  

·         Assist adheres to and implements the philosophy of “hiring the best fit” and ensures that prospective Employees’ personal values are aligned with our core values.

·         All communications and relevant information pertaining to the team are cascaded to the proper channels within team in particular, and organization in general

·         Assist in analyze billing and accounts receivable trends and report on progress, results and conclusions reached regarding:

·         Timely billing of services

·         Collection of services billed

·         Aging of outstanding accounts receivable

·         Unbillable services

·         Write off or adjustment resulting from payor denials or rejections on approval from management

·         Stays focused on maximizing revenue and reducing contractual allowances/ discounts MWS and other (grants) write offs at all times

·         Files all THI claims, Files all THI appeals and corrected claims as needed

·         Handles all communication with insurance/ Medicaid provider relations re: underpayments and /Or denials through to final resolutions

·         Enters and post all service -related (program) payments into IMS software

·         Regularly reviews all clients accounts and keeps them clean, including notifying clients of balances due, issuing check request for refunds due, or making necessary adjusting entries, THIS STEP INCLUDES “COMPLETING” CLAIMS IN IMS ADJUDICATION SO THAT THE CLAIMS ARE PROPERLY & TIMELY CLOSED

·         Assist Director of Finance (DOF) in accounts Receivable (A/R) management, links between IMS software and QuickBooks (QB), including email directives to DOF with specific instructions re: clearing client accounts

·         Assist DOF with awareness of Insurance/ Medicaid policy and / or contractual changes and notifies management and/ or program directors as changes occurs

·         Assist with credentialing process

Other Responsibilities:

·         Acts as backup to THI Verification Specialist, Front desk billing associate, Authorizations and check out in their absence or as needed

Education and Experience Requirements:

·         High school diploma

·         Must have three-plus years of claims (Insurance billing) experience

Specific Skills:

·         Knowledge and acquired usage of Microsoft standard programs; in particular, Microsoft Word and Excel

·         Good communication skills, particularly with inter-departmental communications

Key Competencies:

·         Verbal and written communication skills

·         Professional personal presentation

·         Standard PC usage

·         Office Organization

·         Reliability

Basic Competencies:

·         Internet- using the internet for filing claims, gathering information, and communicating

·         Spreadsheets- knowledge and ability to create, modify and electronically transmit

·         Email and fax machine knowledge and familiarity 

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