Team Leader, Commercial & Denials

Description

JOB SUMMARY
Coordinates and supervises the Commercial Billing and Denials Follow Up areas. Responsible for the hiring, training and disciplinary procedures of the teams under the direction of the Patient Account Director. Responsible for training staff and maintaining computer systems on Third Party Insurance rules and regulations updates related to billing and follow-up functions. Responsible for collection activities on accounts that involve legal or quasi-legal efforts as well as accounts that have specific laws directing the process for Phoebe Putney Memorial Hospital. Maintains adequate staffing of the department and provide direct support when required. Maintains supplies and equipment necessary to operate the department and monitor costs associated with area operation within established budget guidelines.

GENERAL REQUIREMENTS
Adheres to the hospital and departmental attendance and punctuality guidelines

Performs all job responsibilities in alignment with the core values, mission and vision of the organization

Performs other duties as required and completes all job functions as per departmental policies and procedures

Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs)

Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.

Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs. For non-clinical areas, has attended training and demonstrates usage of age- specific customer service skills.

Must have a general understanding of accounting principles, and the Federal Income Tax Code.

WORKING CONDITIONS
General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels.

May be exposed to high noise levels and bright lights.

May be required to change from one task to another of different nature without loss of efficiency or composure.

Periods of high stress and fluctuating workloads may occur.

May be scheduled as needed including overtime

Qualifications

EDUCATION REQUIREMENTS
2 year / Associate Degree in Business Administration or related field (Required)

4 year / Bachelor's Degree in Business Administration or related field (Preferred)

EXPERIENCE REQUIREMENTS
4 - 5 years supervision (Required)

4 - 5 years revenue cycle in a healthcare environment, preferably acute and sub-acute care hospital setting (Required)

CERTIFICATIONS AND LICENSURES
Required Certifications/Licensures: Certified Patient Account Representative (CPAR)

GENERAL SKILLS
Organizational
Skills

Communication Skills

Interpersonal Skills

Customer
Relations

Mathematical

Analytical

Grammar / Spelling

Read / Comprehend Written Instructions

Follow Verbal
Instructions

Basic Computer Skills

Microsoft Office Suite

General Clerical
Skills

Ability to coach and develop personnel

Must have knowledge of Medical
Terminology and Third Party Insurance Carriers

Must have knowledge of Third
Party Insurance Carriers

Must have knowledge of Medical Terminology and Third
Party Insurance Carriers

Thorough understanding of HCPCS, CPT, diagnosis codes
and revenue codes

A proven track record in effective problem solving, analytical
ability and strong leadership skills required

Self-starter with a high degree
of organizational and motivational skills.

PHYSICAL REQUIREMENTS
Have near normal vision - Clarity of vision (both near and far), ability to distinguish colors

Have good - manual dexterity and eye-hand-foot coordination

Ability to perform - repetitive tasks/motion

PHYSICAL DEMANDS
Standing - Occasionally within shift (1-33%)

Walking - Occasionally within shift (1-33%)

Sitting - Continuously within shift (67-100%)

Bending/Stooping - Occasionally within shift (1-33%)

Twist at waist - Occasionally within shift (1-33%)

Lift/carry > 20 lbs with assistance - Occasionally within shift (1-33%)

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