Medical Billing – Appeal – Financial Lead
Remote / Work from Home
Starting Pay: $19.00
JOB SUMMARY
The Appeal Lead provides leadership and oversight to the Revenue Cycle employees to ensure an overall high level of quality, efficiency, and productivity, while affirming all departmental goals are satisfactorily met. Maintains a physically, mentally, and environmentally safe work environment for all employees. Provides a positive work environment and mentors employees by providing purpose, motivation, and direction in-order-to accomplish the department’s mission.
ESSENTIAL FUNCTIONS/DUTIES
Effectively train/lead billing processes in a remote worker atmosphere
Maintain a working knowledge of billing regulations and follow-up collection trends with a diverse group of national payors.
Assure process and resources are allocated to provide required payor documentation assembly and filing in a timely manner.
Gather, analyze, and identify billing and/or follow-up problems recommending corrective actions and procedural changes.
Analyze work processes to maximize efficiency.
Monitor goals and motivate employees to foster high performing teams.
Work effectively as a member of a leadership team.
Communicate clearly and concisely, both orally and in writing, giving presentations as needed.
Serve as a “champion” for best practices within our “I-Care” Cultural Pillars. (Integrity / Compassion / Accountability / Responsibility / Excellence)
QUALIFICATIONS
Required Experience
Must be fluent in English
Minimum of 1 Year – 3 Years Preferred: Full-time experience with direct responsibility for delivery of patient accounting services and healthcare billing and follow-up services
Minimum of 1 Year – 3 Years Preferred: Post bill experience with in-depth/advanced knowledge of Medicare and Medicaid.
Minimum of 1 Year – 3 Years Preferred: Experience of appeal processes.
Working knowledge of health care billing procedures, reimbursement, third party payer and compliance regulations, documentation, and standards
Working knowledge and understanding of payor Explanation of Benefits (EOB)
Preferred Experience
Minimum of 3 years working in a call center environment
Minimum of 3 years working in customer service
Proficient in Word, Excel, Office 365
Required Education
High school diploma or equivalent
Skills
Ability to work independently or as an active member of a team
Must possess empathic and professional written and verbal communication skills
Knowledge and experience of computers and related technology, at an intermediate level
Organized with good time-management skills
Requires strong problem-solving skills, attention to detail, and ability to make timely decisions
Intermediate computer skills and familiarity with Microsoft Office, especially Excel
Ability to drive results, review/improve processes, and manage change
Excellent internal and external customer service skills
Responsiveness and a strong commitment to meeting internal and external deadlines with limited supervision
Strong written and verbal communication skills and interpersonal skills
Strong quantitative, analytical, and problem-solving skill
Working Conditions
Work in a team environment
Utilize various software programs
May be required to sit for long periods of time
Mental Demands
Critical thinking skills with the ability to use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems
Guiding Values and Behaviors of Patient Accounts Billing Representative
Employee must consistently exhibit our guiding principles:
Patient Care – We continually earn the privilege to care for our patients. It is at the forefront of everything we do.
One Team – We respect each other and achieve together what no individual can achieve alone.
Innovation – We are driven to develop solutions that inspire progress.
Vigilance – We will never waver in our commitment to safety and preparedness in the fulfillment of our duties.
Ownership – We are accountable for what we do and take pride in how we do it.
Citizenship – We are dedicated to being good stewards in the communities we serve.