CBO Patient Financial Services Lead

Position Summary / Scope of Responsibility

MedVanta is the nation's largest physician-owned and operated next generation management services organization (MSO). Our services are specifically designed for musculoskeletal (MSK) providers and go beyond that of a traditional MSO, empowering our clients with the precise infrastructure, data, technology, and administrative processes needed to thrive both today and tomorrow.

MedVanta has an employee centered culture that supports and promotes diversity and inclusion. Our encouraging and empowering management style makes MedVanta a great place to further grow your knowledge while building a team driven path to success.

The Patient Financial Services Lead is responsible for performing a variety of complex customer service-related functions through the Central Billing Office (CBO) Call Center. These include team member management, collection of prior debt, addressing billing questions, establishing payment plans, screening for financial assistance, responding to Chart inquiries and other customer service requests.

Primary Responsibilities

• Team Management: Oversee and guide a team of PFS representatives, ensuring productivity and adherence to policies
• Assist with the preparation of the Monthly Pre-collection/Collection Agency Files
• Audit team performance and results, adjusting for improvement as indicated
• Process Improvement: Identify inefficiencies and implement strategies to improve workflows and team performance.
• Identify and propose opportunities to maximize Patient AR revenue
• Carry out talent management processes, including training, development, and evaluation of staff
• Training & Onboarding: Train new hires and provide ongoing coaching to team members.
• Complete and provide timely reporting to billing leadership, including standard weekly reports
• Reporting & Analytics: Oversee critical reports such as card on file reports, statements on hold, and productivity metrics.
• Perform all medical billing responsibilities in support of the team, including:
• Handle insurance billing/claims
• Collect, post, and manage patient accounts
• Submit claims to insurance
• Prepare and review patient statements
• Review delinquent accounts and call for collection purposes
• Communicate accurate patient and billing/claims information to insurance carriers
• Answer incoming patient phone calls and make outbound collection calls on open balances
• Update patient insurance, confirming eligibility and queue claims for billing
• Update demographic and guarantor information in the Patient Accounting System
• Handle patient inquiries to address billing questions via inbound calls and patient correspondence
• Fulfill patient requests for itemization of charges, adding/verifying/billing insurance, establishing payment plans, process adjustments, request refunds, and explain policy and guidelines
• Initiate patient outreach on delinquent payment plans, adding accounts to existing payment plans and high risk/balance accounts.
• Review, address and monitor credit balances to ensure compliance with regulatory and contractual obligations
• Identify and troubleshoot patient billing issues to ensure resolution
• Escalation Handling: Manage and resolve complex patient account issues and escalation calls.
  
• Manage and work queues and worklists in patient billing system
• Receive and process patient credit card payments, and allocate to appropriate visits on the account
• Evaluate accounts for bad debt placement and work with bad debt vendor on patient issues and concerns
• Post appropriate discounts and adjustments to patient accounts
• Interact with supporting departments; coding, cash-ops, AR follow up to resolve billing and payment issues
• Meetings & Communication: Lead productivity meetings and serve as the primary point of contact for interdepartmental communication.
• Conform with and abide by all regulations, policies, work procedures and instructions.
• Other duties as assigned.

Reporting Relationships

The Patient Financial Services Representative reports directly to the Patient Financial Services Manager.
This role does have direct reports.

Requirements, Education, and Experience

• High school diploma
• 5 years of related experience, with experience in an orthopaedic setting preferred
• Proficiency with Microsoft Office suite of products as well as electronic billing systems
• Extensive knowledge of insurance, benefits, medical terminology and medical billing

Competencies / Required Skills and Abilities

• Strong Interpersonal Skills - Ability to develop relationships and collaborate and influence in a decentralized organization.
• Demonstrated ability to organize, prioritize, and manage multiple tasks in a dynamic environment with a proven track record of results.
• Strong interpersonal, oral, and written communication skills with excellent self-discipline and patience.
• Able to work independently.
• Exudes professionalism in presentation.
• Must be able to read, write, speak, understand and communicate in the English language.

Physical Demands

• Must be able to sit for long periods of time and lift up to 25 pounds.
• Must be able to use appropriate body mechanics techniques when performing desk duties.
• Requires frequent bending, reaching, repetitive hand movements, standing, walking, squatting, and sitting.
• Adequate hearing to perform duties in person and over telephone.
• Must be able to communicate clearly to patients in person and over the telephone.
• Visual acuity adequate to perform job duties, including reading materials from printed sources and computer screens.