Medicare Specialist Team Lead in Hendersonville, TN at Parallon

Date Posted: 8/7/2018

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 and Billing
 


DUTIES INCLUDE BUT ARE NOT LIMITED TO:

  • Maintains current knowledge of all office operations, job specific requirements and relatedregulations
  • Assists with staff communication, providingupdates, resolvingissues, setting goals and maintaining standards
  • Provides ongoingtraining and educationto staff to ensure policiesand procedures are followed
  • Strives to improvecurrent operations by identifying inefficiencies and recurringproblems 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 expectedgoals are being met and addressesissues with staff membersif the need should occur
  • Meets with Managerregularly to effectively communicate and resolve follow-up issues, set and prioritize goals,improve processes and reviewsfollow-up status
  • Works as a liaisonbetween team membersand management
  • Establish workingrelationships with FI’s and Facility/SSC staff
  • Establish and maintainseffective relations with staff promotinga positive team environment
  • Exercised good judgmentand makes sound decisionsin the absence of detailedinstructions or in an emergency situation
  • Sets a good example for staff by adhering to all office policiesand maintain a positiveattitude
  • Reviews claims for completeness, reasonableness of charges, and appropriateness of billingcodes, and payer information
  • Pursues timelycollection of each claim using thorough follow-up effortsappropriate to each payer
  • Handles all incoming phone calls and inquiriesin an appropriate manner
  • Properly processes and responds to incomingand 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 currentandaccurate account information in each of the appropriate systems(i.e. entering notes, claims on hold)
  • Forwards and logs all documentation related to processes and dutieswhich are transferred to other employees
  • Brings problemsand troubling accounts, as well as related questions, to his/herimmediate supervisor’s attention daily
  • Exercised good judgmentand makes sound decisionsin 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 requesttimely, accurately, and according to instruction.
  • Adapts   and   conforms   to   company   and   client   requirements   not   specified   in   this   job description/performance review

Job Requirements



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 followpriorities
  • Knowledge of hospitalbusiness officeoperations
  • Strong PC and data entry skills
  • Ability to communicate effectively with employees, clients, and others
  • Character to maintainstrict confidentiality

 


EDUCATION

  • High school graduate or equivalent

 


EXPERIENCE

  • Preferred minimum of 2 years Medicare claim processing experience

 


CERTIFICATE/LICENSE - N/A