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CMC - Billing Lead

Company: Conway Medical Center
Location: Conway
Posted on: August 6, 2022

Job Description:

Position Summary:The Billing Lead is responsible for providing leadership and oversight of the Patient Accounts Representatives team for acute claims follow up within the organization. This oversight includes but is not limited to the educational training on the Cerner revenue cycle module and specifically the Cerner work queue. The Billing Lead will also be responsible for education on the SSI Clearing House Billing Systems and be able to address the daily edits and resolution of these edits in a manner. The Billing Lead will present any information as necessary to the director so that appropriate action can be taken to reduce the manual intervention on the claims process. The Billing Lead will be a resource to the PAR when they cannot resolve payer, system or payor issues following the established procedures currently in place. The Billing Lead will meet with the Director on a weekly basis and provide feedback on issues encountered by the PAR team. Review and correctly analyze Insurance AR reports and provides detailed feedback to the Team/Management for statistical AR reporting that falls outside the established benchmarks. The Billing Lead will have direct oversight to ensure effective communication of payor billing guidelines to staff in a timely manner, create action plans related to insurance accounts receivables and executes them accordingly. The Billing Lead must demonstrate a high level of professional integrity when communicating with payors, and staff. The Billing Lead will escalate to management issues that negatively affect accounts receivable, while consistently meeting and/or exceeding AR objectives in each outstanding aging category (30,60,90+) within the assigned PAR Follow-Up Team. Mentors and trains Insurance AR Follow-Up Staff. Oversees and assist Patient Accounts Representatives (PAR) with inquiries and work plans to meet/exceed team goals and objectives. All organizational staff, including this position are specifically required as a condition of continued employment to make advance preparations for their families and pets in the event of weather emergencies such as Hurricanes and flooding threats. Any staff member can be determined as essential staff required to report to the facility during these events. In many cases this means reporting and sleeping at the facility before, during and after a weather emergency. By signing this job description, the staff member accepts this responsibility of readiness to report to work during any designated emergency staffing situation. CMC staff members operate as one team meeting the healthcare needs of our communities, thus this position will on occasion complete other duties as assigned beyond those designated in this primary job description which may include "float" coverage at an alternate facility, department or assignment. Qualifications Assessment of overall credit worthiness by review of a consumer credit report is required. Education: High School diploma or equivalent required. Associate degree preferred. Experience: Minimum of three (3) years' experience in Hospital Billing required. Previous experience working with SSI Clearing House and payor specific billing guidelines required. Previous experience in leading a Billing Team preferred. Special Skills: Work collaboratively with other RCM departments (Clinical, Billing, Posting, Customer Service) to ensure overall account accuracy and issue resolutions are completed. Exceptional verbal and written communication skills Strong organizational skills Ability to multi-task and deal with high volume insurance claim follow-up required. Intermediate to Advanced Skills and experience with office productivity tools such as MS Word, Excel, and Outlook required. Exceptional people skills and ability to oversee the team required. Physical Requirements: Light-Medium - While performing the duties of this job, the employee is frequently (activity or condition exists from 1/3 to 2/3 of the time) required to stand, sit, and walk; frequently to use hands, fingers; and frequently to talk or hear. The employee must exert 15 to 20 pounds of force occasionally (activity or condition exists up to 1/3 of the time), and/or 5 to10 pounds of force frequently, and/or greater than negligible up to 5 pounds of force constantly to move objects. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Ability to hear to process instructions and safety code and alarms required. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job and will be assessed by post offer Employee Health fit-for-duty review.

Keywords: Conway Medical Center, Wilmington , CMC - Billing Lead, Accounting, Auditing , Conway, North Carolina

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