Medicare Specialist Team Lead in Hendersonville at Parallon

Date Posted: 9/27/2018

Job Snapshot

Job Description

GENERAL SUMMARY OF DUTIES - Responsible for monitoring all aspects of Medicare receivable processing, includingbut not limitedto, billing, collection, accountand system maintenance, process reconciliation, and productivity reporting.
SUPERVISOR - Managerof Collections


  • 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 improvecurrent 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 membersif 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 decisionsin 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 requesttimely 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.

Job Requirements


  • 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



  • High school graduate or equivalent



  • Preferred minimum of 2 years Medicare claim processing experience