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Company: MedStar Health
Location: White Marsh, MD
Career Level: Associate
Industries: Not specified

Description

General Summary of Position
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 Duties and Responsibilities


  • Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
  • Assists with the daily audit and review of reports to ensure that verification completed. May monitor the error tracking and other statistical reporting systems communicates to supervisor any trends or problem areas. Investigates monitors and consults with supervisor and makes recommendations to address untimely follow-up of accounts.
  • Assists with the daily/weekly/monthly audit of accounts to ensure that accounts meet department standards. Makes recommendations to supervisor to improve the effectiveness of verification efforts reporting any problems or issues with the process.
  • Assists with review and analysis. Maintains ongoing knowledge of specified forms including state required forms and filing requirements. Communicates problems and issues relative to eligibility conversion to appropriate parties. Acts as a liaison between staff agency and state to resolve issues.
  • Reviews daily reports to insure completion of verification process and readiness of all accounts for and ensuring a standard turnaround time of scheduled services and based on the payer specific requirements for all unscheduled services. Reviews accounts to determine action required utilizes all resources and documentation.
  • Assists the supervisor with the development of financial operational customer service and productivity targets. Assists with selection training and orienting of department staff. Assists with compiling and maintaining an updated training manual. Provides training to staff including training team members in the specific work applications and computer Systems used for department.
  • May assist with the formal performance reviews and provides feedback to Manager in accordance. Provides timely and appropriate verbal counseling of staff when they deviate from department standards; in conjunction with Manager assists in the development of measures to improve performance.
  • May complete timecards and maintains attendance records. Coaches and counsels staff. Initiates or makes recommendations to the supervisor for personnel actions (terminations suspension evaluations interviewing etc.). May conduct staff meetings on a regular basis. Keeps staff informed via in service meetings and memorandums.
  • Identifies and evaluates staff productivity and base workload assignments in conjunction with Supervisor to determine that appropriate allocation of resources standards and staff performance is optimized.
  • May supervises the day-to-day activities of the assigned staff to accomplish the established monthly and quarterly financial and productivity goals. Establishes priorities schedules distributes daily workload and reassigns tasks as necessary.
  • May be accountable for securing information over the phone from the patient or insurance company including pre-collection and preregistration on accounts. Monitors the telecommunications system by measuring voice mail messages voice mail abandonment duration of calls taken per representative and duration that each patient is held in queue etc.
  • Participates in multidisciplinary quality and service improvement teams. Participates in meetings and on committees and represents the department and hospital in community outreach efforts.
  • Minimal Qualifications
    Education
    • High School Diploma or GED required or
    • Associate's degree in healthcare preferred and
    • courses in Accounting Finance and Healthcare Administration preferred
    • One year of relevant education may be substituted for one year of required work experience.
    Experience
    • 1-2 years Experience in patient accounting in a hospital-based department (systems billing medical records registration finance) required or
    • Knowledge of medical terminology and payer billing preferred and
    • Leadership experience preferred
    • One year of relevant professional-level work experience may be substituted for one year of required education.
    Licenses and Certifications
    • Certified Revenue Cycle Specia - CRCSI within 1 Year required or
    • Cert Revenue Cycle Prof-Instit - CRCP-I within 1 Year required or
    • Cert Revenue Cycle Executive - CRCE-I within 1 Year required or
    • Certified Compliance Technician- CCT within 1 Year required or
    • Certified Revenue Integrity Professional- CRIP within 1 Year required or
    • CHAM - Certified Healthcare Access Manager within 1 Year required or
    • CHAA - Certified Healthcare Access Associate within 1 Year required or
    • Hospital Presumptive Eligibility- HPE within 1 Year required or
    • Cert Healthcare Fin Prof - CHFP within 1 Year required or
    • Cert Revenue Cycle Rep - CRCR within 1 Year required
    Knowledge Skills and Abilities
    • 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.

    This position has a hiring range of

    USD $20.57 - USD $36.27 /Hr.


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