What are the responsibilities and job description for the Team Leader Patient Accounting - Accounts Resolution Division position at medstar?
MedStar Health’s Patient Financial Services team has an opening for a TEAM LEADER to join our Account Resolution Division (ARD). We are specifically looking for a candidate that has advanced knowledge and experience with facility claims follow-up, researching high dollar claim denials and preparing/writing appeals to get claims paid.
The ARD Team is responsible for handling all Medicare Exhaust Claims, COB denials; and High dollar accounts exceeding $100K account charge at the time of billing for Maryland facilities and $500K reimbursement for DC facilities.
Full time, HYBRID schedule, working 4 days a week remotely and only 1 day in the office. Position does require on-site training (up to the first 90 days of employment) in our business office located in Nottingham, Maryland.
Job Summary: Provides guidance and assists staff with review and analysis of various reports in assigned area. In cooperation with Supervisor, identifies and analyzes errors to determine action needed for performance improvement. In conjunction with level II Insurance Specialists, assists in researching and addressing administrative customer service issues. Works with all team members to resolve multiple primary and secondary billing, collection, customer service issues with payers and patients.
Primary Responsibilities
· Researches and analyzes complex and escalated accounts to identify and complete appropriate steps needed for resolution including, but not limited to, the research and resolution of Medicare Exhaust, Coordination of Benefit conflicts, Recovery Audits, and MSP Verification. Recognizes, documents and communicates account and payer trends. Works in collaboration with all teams, payers and patients, utilizing resources to resolve multiple primary and secondary billing, collections, and customer service issues.
· Maintains daily performance benchmarks pertaining to follow-up. Maintains departmental QA standards within standard error rate.
· Processes and completes the daily billing of paper claims including timely communication back to the Billing Team as appropriate.
Qualifications:
- High School Diploma or GED required
- Associate’s degree in healthcare Preferred or courses in Accounting, Finance and Healthcare Administration preferred
- 1-2 years’ experience in patient accounting in a hospital-based department (systems, billing, medical records, registration, finance) required
- Detailed working knowledge and demonstrated proficiency in the major (Medicare, Medicaid and Blue Cross) payer's application billing and/or collection process, with particular focus on billing specifications and contractual arrangements and/or multiple payer's insurance verification and pre-certification guidelines.
- Ability to resolve complex payer issues to completion, training individuals in the billing and collection processes.
- Excellent communication and interpersonal skills.
- Excellent organizational skills to manage multiple tasks in a timely manner.
- Proficient use of hospital registration and/or billing systems, and Microsoft Word and Excel software applications.
- One of the following certifications required within 1 year of hire date:
- Certified Revenue Cycle Specialist - CRCS; Cert Revenue Cycle Rep - CRCR; Cert Revenue Cycle Prof-Instit - CRCP; Cert Revenue Cycle Executive - CRCE; Certified Compliance Technician- CCT; Certified Revenue Integrity Professional- CRIP; CHAM - Certified Healthcare Access Manager; CHAA - Certified Healthcare Access Associate; Hospital Presumptive Eligibility- HPE; Cert Healthcare Fin Prof - CHFP
Salary : $100,000
