Patient Account Representative - Lead

Position Objective: Under the direct supervision of the Physician Reimbursement Supervisor, the Lead Patient Accounts Representative works in the Professional Billing Office (PBO) providing continuous support and education to our internal and external teams in regards to collections, adjustments, appeals, remittance review, etc. This will include review and working accounts alongside team members as well as reviewing adjustments and refund requests for approval. Communication of account details, payer issues, and other ongoing concerns affecting collections to management is required.

The Lead Patient Accounts Representative serves as a main resource for assisting support staff with billing related services and acts as a subject matter expert for workflow related questions/concerns. Responsible for escalating issues to the Supervisor of Patient Accounts as needed for assistance in resolution. The incumbent is also expected to function as a Patient Accounts Representatives and/or other assignments delegated by management.

Responsibilities

: Functions as a primary resource for questions and project related matters. Assists in furthering the development of the physician reimbursement team by setting the tone for the team’s work ethic, efficiency, proficiency, and professionalism. Presents to medium-large audiences regarding revenue cycle workflows and upgrades in various systems.

Exhibits Proficient Use of EPIC System: Efficient utilization of and training on the billing system database to update facility file and patient demographic information; ability to edit a claim and send/receive claim notes in the billing system. Ability to fully train on and work all work queues. Competence with Insurance Issues: Demonstrated ability to post charges, payments, adjustments, and knows how to work undistributed payments.

Understands claims overpayments, collections, and pre-bill/post-bill work queues. Possesses competency of medical coding knowledge. Demonstrates the ability to train on the processes.

Serves as a payer liaison to streamline communication of policy updates and revisions to staff Organizational Efficiency: Effectively maintains follow up account activity by ensuring the proper organization, time management, tracking, resolution, and documentation of all correspondence. Facilitates workflow for accounts receivable and claims submission. Reviews denials and accounts deemed uncollectible by Primary Billing Team staff.

Recommends additional steps to prevent losses or determines account collectible, selects appropriate adjustment code for denial tracking and resolution. Immediately alerts department leadership to new or emerging trends in denials. Able to serve as a cross functional resource to our Customer Service, Revenue Integrity and Cash Operations Teams.

Responsible for special projects assigned by Physician Reimbursement Supervisor and/or Physician Reimbursement Manager. Assists with training and onboarding of all new staff and does special projects as assigned by management. Reports metrics, trends to Physician Reimbursement Supervisor promptly.

Works with Supervisory and Revenue Integrity teams to adapt and revise Standard Operating Procedures and Training Workflows.

Requirements

: High School Diploma or equivalent (GED) required. Excellent interpersonal and communication skills. The ability to work collaboratively in a team setting as well as external and internal departments.

Three or more years of experience in professional billing and or revenue cycle operations. Proficient in teaching and providing appropriate feedback. Highly organized, detail oriented and flexible, ability to re prioritize work, adapt to new processes timely.

Preferred Qualifications

: EPIC system experience preferred Technical Medical Billing Coding certifica