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Company: MedStar Medical Group
Location: Baltimore, MD
Career Level: Associate
Industries: Not specified
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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


  • 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.
  • Assures that all payment batches are forwarded to the Imaging department by department set standards the following business day. Ensures the accuracy of the Archive Lockbox Control Log and its timely completion. Assures that payments, allowances and discounts are processed within 24 hours of receipt, with no more than a 3% error rate. Reports inability of department to meet deadlines to Supervisor of the department as well as the Supervisor of the Document Imagining Support Services.
  • Provides coverage for staffing vacancies. Provides guidance to associates engaged in posting of self-pay and third party payments to accounts receivable, assuring training in the applications of the SMS, McKesson and other applicable systems related to payment applications. Ensures that the Training Checklist is complete and validates by audit understanding and compliance.
  • Reviews unidentified live checks daily to ensure that they are either deposited timely, or forwarded to the appropriate department (Accounts Payable, Payroll, Accounting) for review. Works directly with the Part B vendor, Cashier department and Customer Service department at Georgetown University to ensure that all files (i.e.: Cashier, JV, and Transfer Requests) are sent, received and posted timely. Works with Information Systems to ensure compliance and functionality, both with system and electronic posting sent for grant and nursing home payments.


    • Minimal Qualifications
    Education

    • High School Diploma or GED required
    • Associate degree in healthcare preferred
    • 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
    • Knowledge of medical terminology and payer billing preferred
    • 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, Cert Revenue Cycle Prof-Instit - CRCP-I, Cert Revenue Cycle Executive - CRCE-I, Certified Compliance Technician- CCT, Certified Revenue Integrity Professional- CRIP, CHAM - Certified Healthcare Access Manager, CHAA - Certified Healthcare Access Associate, Hospital Presumptive Eligibility- HPE, Cert Healthcare Fin Prof - CHFP, 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 $20.57 - $36.27

     


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