Acelity Careers

Recert Healthcare Billing Specialist Team Lead

San Antonio, United States of America
Customer Administration


Job Description

The Healthcare Billing Specialist Team Lead position is responsible for:
•    Processing claims paperwork and serving as a claims specialist Team Leader for assigned team(s)
•    Providing guidance and technical training to claims specialists
•    Assists with daily document collection during peak periods
•    Assists with escalated issues; acts as point-of-contact for assigned team members
•    Participates in meetings with Field Sales, Service and Advantage Center teams

PRIMARY DUTIES/RESPONSIBILITIES:

  • Provide support to Supervisor, particularly in the area of training, monitoring reports, setting goals, tracking trends, work guidance, and assisting with escalated issues and special projects
  • Assist with problem resolution and ensure work is performed accurately, and in accordance with department Standard Operating Procedures, HIPAA, and regulatory guidelines
  • Provide Supervisor with input and assistance to maintain established performance goals
  • Provide team members with required technical coaching and development
  • Assist with escalated calls and internal/external customer issues; research problem situations
  • Makes copies of supporting documentation for discrepancies uncovered (for Region Supervisor review and claims specialist training)
  • Monitor Ship Pending log or Recert Work daily.  Prioritize orders, review and update Genesis notes daily for each order and take required actions to coordinate timely delivery of VACs and surfaces
  • Coordinate delivery with the sales rep or clinical consultant when assistance is needed
  • Reviews Excel QA spreadsheets with Region Supervisor prior to meeting with claims specialist
  • Monitors error trends, and reviews with/trains claims specialist
  • Maintains QA Error Correction Log for each claims specialist to ensure timely completion of error corrections
  • Provides recommendations to training department for changes to the training protocol
  • Prepare IS Requests for system enhancements based on QA review, and participate in pre-implementation testing for these enhancements
  • Processing claims paperwork, including (e.g., ISOP, RX, LMN, CPR, and other documents) for Medicare orders for the Home and Extended Care environment by monitoring key reports (e.g., unbilled document issues report, Web Intelligence unbilled claims, ship pending and VAC responsibility matrix) and by following up with physician offices, Home Health Agencies (HHAs), Wound Care Clinics (WCCs), discharge planners and patients
  • Training and mentoring of new hires
  • Function as the "go to" lead person for the region
  • Assist the Supervisor in report monitoring
  • Handle other overflow responsibilities, as assigned by the Team Supervisor

QUALIFICATIONS:

REQUIRED QUALIFICATIONS:

a)   BASIC QUALIFICATIONS

  • High School Diploma or equivalent
  •  At least (3) years experience in healthcare claims processing including, medical billing and  customer service
  •  Experience with Microsoft Office applications including:  Word, Excel, & Outlook

b)   OTHER REQUIRED QUALIFICATIONS

In addition to the basic qualifications listed above, the following other position qualifications are required:

  • Excellent telephone customer service skills.
  • Experience with KCI Filenet, Hero and claims
  • Experience with creating and evaluating claims reports
  • Demonstrated use of effective problem-solving and telephone customer service skills.
  • Demonstrated presentation and communication skills
  • Ability to work effectively in a team environment, as well as independently.
  • Ability to manage time and deliver results under tight deadlines
  • Ability to maintain confidentiality and discretion in business relationships and dealing with patient information
  • Ability to deal with employee and business contacts while conveying a positive customer service-oriented attitude

ESSENTIAL FUNCTIONS:

The Claims Specialist Team Leader position is responsible for processing claims paperwork and serving as a claims specialist team leader and requires ongoing computer usage (more than 85% of time) and repeated computer keyboarding.

The information listed above is not a comprehensive list of all duties/responsibilities performed. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice. Any physical and mental requirements described in this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EOE AA M/F/Vet/Disability: Acelity L.P. Inc. and its subsidiaries are an equal opportunity and affirmative action employer and give consideration for employment to qualified applicants without regard to race, ethnicity, color, religion, sex, sexual orientation, gender identity, pregnancy, national origin, age, disability, veteran status, or genetic information or any other legally protected characteristic. If you'd like more information about your EEO rights as an applicant under the law, please click here: http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf VEVRAA Federal Contractor