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Medicare Specialist Team Lead in Hendersonville at Parallon

Date Posted: 4/29/2019

Job Snapshot

Job Description

Parallon believes that organizations that continuously learn and improve will thrive. That’s why, after more    than a decade, we remain dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry’s leading providers of business and operational services.  Parallon is uniquely equipped to provide a broad spectrum of customized revenue cycle services.
 
  JOB TITLE: Medicare Specialist Team Lead
 
GENERAL SUMMARY OF DUTIES - Responsible for monitoring all aspects of Medicare receivable processing, including but not limited to, billing, collection, account and system maintenance, process reconciliation, and productivity reporting.
 
SUPERVISOR - Manager of Collections and Billing
 
SUPERVISES – Billing and Collection staff
 


DUTIES INCLUDE BUT ARE NOT LIMITED TO:

•          Maintains current knowledge of all office operations, job specific requirements and related regulations
•          Assists with staff communication, providing updates, resolving issues, setting goals and maintaining standards
•          Provides ongoing training and education to staff to ensure policies and procedures are followed
•          Strives to improve current operations by identifying inefficiencies and recurring problems and by making suggestions to management and education department
•          Directs staff daily to ensure daily work flow is current
•          Monitors staff’s performance to ensure expected goals are being met and addresses issues with staff members if the need should occur
•          Meets with Manager regularly to effectively communicate and resolve follow-up issues, set and prioritize goals, improve processes and reviews follow-up status
•          Works as a liaison between team members and management
•          Establish working relationships with FI’s and Facility/SSC staff
•          Establish and maintains effective relations with staff promoting a positive team environment
•          Exercised good judgment and makes sound decisions in the absence of detailed instructions or in an emergency situation
•          Sets a good example for staff by adhering to all office policies and maintain a positive attitude
•          Reviews claims for completeness, reasonableness of charges, and appropriateness of billing codes, and payer information
•          Pursues timely collection of each claim using thorough follow-up efforts appropriate to each payer
•          Handles all incoming phone calls and inquiries in an appropriate manner
•          Properly processes and responds to incoming and outgoing correspondence
•          Contacts and effectively communicates with all parties involved in the resolution of accounts placed
•          Completes work request timely and in accordance with instruction
•          Performs all of the tasks necessary to maintain current and accurate account information in each of the appropriate systems (i.e. entering notes, claims on hold)
•          Forwards and logs all documentation related to processes and duties which are transferred to other employees
•          Brings problems and troubling accounts, as well as related questions, to his/her immediate supervisor’s attention daily
•          Exercised good judgment and makes sound decisions in the absence of detailed instructions or in a emergency situation
•          Treats client request with a high priority.  Quickly informs supervisor and any other personnel needed to help carry out the request timely, accurately, and according to instruction.
•          Adapts   and   conforms   to   company   and   client   requirements   not   specified   in   this   job description/performance review


 
  • Promotes the Medicare Service Center and helps to identify the necessary resources to meet the needs of its customers
  • Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
  • Other duties as assigned

 


KNOWLEDGE, SKILLS & ABILITIES

  • Knowledge of Medicare regulations
  • Knowledge of UB-04 billing
  • Knowledge of ICD-9 and CPT-4 coding
  • Analytical and organizational skills
  • Ability to identify, set, and follow priorities
  • Knowledge of hospital business office operations
  • Strong PC and data entry skills
  • Ability to communicate effectively with employees, clients, and others
  • Character to maintain strict confidentiality

 


EDUCATION

  • High school graduate or equivalent

 


EXPERIENCE

  • Preferred minimum of 2 years Medicare claim processing experience

 


CERTIFICATE/LICENSE - N/A

 
PHYSICAL DEMANDS/WORKING CONDITIONS - Requires prolonged sitting, some bending, stooping and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports.  Requires lifting papers or boxes up to 25 pounds occasionally. Work is performed in an office environment. Work may be stressful at times. Contact may involve dealing with angry or upset people. Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations.