RCM Payment Processor, Team Lead presso ALLERGY PARTNERS

Description

Ensure all insurance and patient payments are posted quickly and accurately.

Responsibilities include, but are not limited to, the following:

Posting Duties

• Posts all insurance and patient payments by line item; batching them according to protocol.
• Ensures totals balance with what is posted into the computer system, submitting documentation as required.
• Maintains working knowledge of charge entry, and insurance follow up protocols; provides backup to others as needed.
• Work closely with the team to ensure that all posting is completed in a timely and accurate manner, remaining flexible and willing to help where needed.
• Communicates new information as obtained that may assist the team in performing the functions of the department.
• Demonstrates professionalism and promotes positive interpersonal relations with all internal and external business contacts, representing the corporation in a positive manner, and displaying personal commitment to achieving the goals and objectives of the corporation.

Team Lead Duties This position is responsible for ensuring the department runs smoothly, all items are posted accurately and efficiently, assisting where needed, and that the department maintains good communications and working relationships with others in Allergy Partners. The duties listed below are primarily the responsibility of the Team Lead; however, some of these may be shared with other Team members. At all times another person must be trained on duties as a backup.

• Continuously monitor items- EFTs, zero pays, insurance credit card payments - be posted and encouraging the Team to act.
• Continuously communicate with the team, Supervisor and Director on status. The goal
  should be to strive to have items posted within 24 hours.
• Work with Team to cover members that are absent.
• Have the ability to step into any job within the department.
• Work closely with Balancing to insure we are supplying the information they need, to
  include:
  • Ensuring all batches are balanced daily,
  • Submitting data to the Balancing team in a timely manner,
  • Answering any questions from the Balancing team, and
  • Regular communication with Balancing to insure smooth hand off of data.
• Facilitate training and auditing, to include:
  • Training new Payment Posters,
  • Retraining Payment Posters as needed,
  • Performing auditing of payments posted,
  • Answering questions for fellow Payment Posters or other departments,
  • Providing feedback to fellow Payment Posters, supervisor and Director, and
  • Responding to inquiries from other departments concerning posting questions.
• Review, update and maintain posting policies and procedures and insure they are being followed.
• Maintain good communications with others in the CBO and company, including answering questions regarding posting.
• Continuously looking for more efficient way to work- quality and quantity.
• Being a cheerleader for the department.

Other

• Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by the practice.

• Maintains detailed knowledge of practice management and other computer software as it relates to job functions.
• Attends OSHA, HIPAA, and OIG training programs as required.
• Attends all meetings as requested including regular staff meetings.

• Attends Medicare and other continuing education courses as requested. Pursue and participate in education to remain current with changes in the Healthcare industry.

• Performs any additional duties as requested by the CFO and/or Director of Central Billing Services.

Supervisory Responsibilities

This job has no supervisory responsibilities

Typical Physical Demands

Physical demands are moderate with occasional lifting of items weighing approximately 20-30 pounds. Position requires prolonged sitting, some bending, stooping, and stretching. Good eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment is also required. Employee must have normal range of hearing and vision must be correctable to normal range to record, prepare, and communicate appropriate reports.

Typical Working Conditions

Normal office environment. Occasional evening or weekend work.

Qualifications

EDUCATIONAL REQUIREMENTS:

• High school diploma required

QUALIFICATIONS AND EXPERIENCE:

• Minimum eighteen months experience in a medical office reimbursement department.
• Knowledge of practice management and word processing software.
• Proven understanding of Explanation of Benefits forms, claim forms and the insurance billing process.
• Working knowledge of managed care, commercial insurance, Medicare, and Medicaid reimbursement.
• Basic knowledge of CPT and ICD-10-CM coding.
• Strong written and verbal communication skills.