Lead Accounts Resolution Rep

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift

Day (United States of America)

Job Summary:

Under the direction of the Manager of Account Resolution, The Lead assists with planning and coordinating all HB Accounts Resolution department activities for an account receivable portfolio of ~ approximately $375M-$500M, including, but not limited to training employees, as circumstances dictate. The Lead of Accounts Resolution and Denials Management must ensure eligible accounts are reviewed, appealed, escalated or adjusted within the designated payer time frames and are documented appropriately in the patient accounting system, assist with the a continuous improvement work environment, daily operational needs for all governmental and / or non-governmental insurance follow-up related functions and provide the enterprise with denial management and educational support in a variety of departmental and individual settings. The role requires data analysis, trending analysis, workflow design and departmental educational capabilities regarding payor and revenue cycle business related processes. This role requires a versatile and well developed understanding with demonstrated knowledge of billing, collections, denial management, contractual provision interpretation and provider / payor appeal requirements. In addition to a strong understanding and capability of common business technologies such as MS Office, Excel, PowerPoint, Word and Outlook to perform and communicate the assessment and analysis of multiple acute care and LTAC facility accounts receivable portfolios. The core role focus of this position is to ensure that accounts are brought final resolution through reimbursement for services and to mitigate financial losses through solid operational execution, development and conformity to defined Policies and Procedures. The Lead must possess the ability to assist with developing and documenting action plans for quick resource deployment, communicate timely with leadership and staff to understand the specific reasons for payment delays. The role requires the ability to effectively and efficiently communicate both orally and in writing to Leadership and staff, multi-task, meet deadlines, enforce organizational policies and procedures, maintain high staff engagement, staff productivity, and effective operational execution. In addition, the Lead will assist with additional Revenue Cycle related tasks and duties as assigned.

Core Responsibilities and Essential Functions:

Maintain a working knowledge of all-departmental billing and follow-up processes and functions, responding appropriately to inquiries from patients regarding accounts, collection issues and hospital policies, to insure a minimal Accounts Receivables inventory. * Demonstrate effective departmental leadership, and provide direction to the Follow-Up staff in the performance of their daily functions by assisting with daily planning, organizing, prioritizing and management of operations, review accounts receivables evaluating trends, optimizing workflow and process to reduce AR growth, quickly creating action plans to reduce trends, resolving issues, etc. * Assist staff by providing direction and guidance, creating a team environment through training, recognition/evaluation, and in-service education which produces optimum work habits and job performance * Assist with setting obtainable strategic and short-term goals, maintaining expected level of Lead productivity as well as assisting with performance studies to improve productivity, streamline operations and reduce error rates. Provide staff training and oversight that newly implemented policies and procedures are being followed. Meet deadlines established through interaction with the Manager of Accounts Resolution or other senior leadership. * Review and improve work procedures to ensure that the most productive and efficient methods are used * Monitor progress for each area on a daily basis, utilizing quantitative productivity reports and providing feedback to staff * Provide assistance with departmental projects and presentations, as needed. * Maintain and reflect a positive team attitude, regarding any special projects or polices that are implemented by the Revenue Cycle or other senior leadership. * Resolve complaints and misunderstandings in a timely and appropriate manner while demonstrating the ability to tactfully handle difficult situations through an approach that reflects