Lead Patient Account Specialist (Revenue Cycle Self Pay)

JOB SUMMARY: 
The Patient Account Specialist (Rev Cycle Self Pay) Team Lead is responsible for leading the patient account follow-up and billing management. This role coordinates activities, schedules work assignments and ensure that work queues are worked and maintained by the Patient Account team. Researches, resolves, and coordinates responses to patient complaints from government agencies. Produces, analyses, and maintains PAS and Self-Pay key metrics (i.e., statement collection rate, abandonment rate, self-pay aging, calls and emails resolution rates)

JOB REQUIREMENTS: 

Education: 

• High School Diploma or GED required
• Associate degree in Business Administration or related field preferred.

Work Experience: 

• 2 years of hospital or medical billing-related experience required
• Two years of call center experience required
• Proficient in the English language. Being bilingual (Spanish) is a plus.

Preferred Licenses/Certifications:

• CPAR – Georgia Certified Patient Account Representative preferred
• CRCR – HFMA Certified Revenue Cycle Representative (Healthcare Financial Management Association) preferred

Essential Functions:

• Evaluates and monitor PAS workflow. Delegates work with representatives as needed.
• Research, resolve, or provides direction on representatives' escalated issues.
• Develops training materials and trains representatives on revenue cycle policies and procedures.
• Coordinates adjustments to schedules and assignments as needed to achieve operational goals.
• Monitors representatives for quality and training purposes during down times.
• Contributes to the Patient Account Services department workload of representatives including auditing work for accuracy and completeness, re-assigning work and establishing priorities.
• Identifies and research account issues or questions and follow through to resolution
• Assists team members in resolving complex or escalated issues
• Assists PAS leader in evaluating and developing team members to their fullest potential
• Assists specialists in procuring the information they require to succeed at their job duties.
• Communicates regularly with the department leader regarding the status of assigned accounts and employee performance.
• Maintains appropriate files and records per policy and department guidelines
• Maintains compliance with company policies and procedures.
• Assists department leader with interviewing and evaluating potential new employees.
• Performs other related duties and special projects as requested.
• Reviews, resolves, and coordinates responses to patient complaints from government agencies.
• Produces, analyses, and maintains PAS and Self-Pay key metrics (ie. statement collection rate, abandonment rate, self-pay aging, calls and emails resolution rates).
• Monitors representatives’ quality assurance of team’s adherence to script, customer service quality (recorded phone calls) and system documentation.

Additional Knowledge, Skills, and Abilities Required:

• EPIC and eClinical Works EMR systems experience preferred.
• Strong knowledge of medical billing processes, insurance carrier payment policies, and practices
• Knowledge of CPT, ICD-9, and medical terminology required
• Strong organizational skills
• Initiative-taking and direction in the execution of daily responsibilities and identification or resolution of issues within the span of authority
• Clear, concise, and professional verbal and written communication skills, proficient in English
• Strong listening and people skills
• Ability to identify, research, and resolve issues
• Computer and MS Office skills required
• Superior customer service skills
• Ability to prioritize multiple tasks.