Billing Operations Lead

Summary

The Team Lead serves as an immediate resource for all third party revenue cycle functions within the department and is responsible for all desk-side Training of new hire Billing Operations Associates. The Team Lead also assists the Billing Operations Supervisor with running reports and delegation of work to the Associates.

Pay Class and Pay

Pay Class: Full Time and Remote

Pay: $17.16 - $22

Essential Responsibilities

• Assist the claims and exceptions processors with all aspects of claim submission.
• Monitor unpaid claims assigned to the processors and collectors. Assist with follow up for payment as needed.
• Coordinate EDI claims issues with EDI support team and Billing Operations Supervisor.
• Monitor and assist Billing Operation Associates with patient billing.
• Coordinate provider/credentialing and plan set up issues with the managed vision care department.
• Contact resource center to assist Associates with computer system issues.
• Assist in the development, planning, monitoring and facilitation of one on one claim processing training sessions with newly hired Billing Operation Associates.
• Cross-train with fellow department team leaders.
• Perform other duties as requested and assigned by billing supervisor/manager.
  
  

Education

• High School Diploma, GED, or equivalent work experience
  
  

Experience & Background

• Two to three (3) years of experience in medical insurance claims billing required
• Proficiency in MS Excel and Word
  
  

Language Skills

• Well-developed verbal, listening and phone communication skills
• Good written communication skills with the ability to write routine correspondence
  
  

Mathematical Skills

• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
  
  

Reasoning Ability

• Ability to define problems, collect data, establish facts, and identify trends.
• Ability to exercise good judgment and escalate issues appropriately
  
  

Essential Responsibilities Related To Physical Demands/Work Environment

The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the associate is required to stand, use hands and fingers to handle, feel, pick or pinch, and talk or hear most of the time. The associate is occasionally required to stand, walk, and reach with hands and arms. The associate must frequently lift and/or move up to 20 pounds. The noise level in this location is moderate (use of computers, printers and machines).

Activity

Amount of Time

None

Under 1/3

1/3 to 2/3

Over 2/3

Stand

x

Walk

x

Sit

x

Use hands to finger, handle, or feel

x

Reach with Hands and Arms

x

Climb or balance

x

Stoop, kneel, crouch, or crawl

x

Talk or hear

x

Close Vision (clear vision at 20” or less)

x

Essential Responsibilities Related To Behavioral Characteristics

• Strong organizational skills and ability to execute manual detailed tasks.
• Strong customer service focus and commitment.
• Ability to establish and maintain effective working relationships within the team.
• Ability to get along with diverse personalities; tactful, mature and flexible.
• Work in fast pace environment with interruptions and deadlines.
• Ability to work onsite and participate in interactive onsite meetings on a regular and predictable basis.
• Ability to initiate immediate interaction, coordination and collaboration with team members, clients, customers etc.
  
  

HIPAA & Security Requirements

All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.

Visionworks is an equal opportunity employer, committed to the hiring, advancement and fair treatment of individuals without regard to race, color, religion, sex, age, sexual orientation, gender, national origin, ethnicity, disability or veteran status, or any other protected status designated by federal, state or local law.

The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria considered necessary to perform the job successfully. As required by changing business needs, complete additional essential responsibilities as identified and assigned.