Team Lead, Insurance Billing

• Team Lead, Patient Financial Services Follow up, Days, 80 Hrs / 2wks
• Location: Janesville, WI, OR Rockford, IL
• Hybrid remote optional as well and flexible work schedule available.

Works in collaboration with the leadership team on communicating follow-up policies, procedures and providing department workflow training to all partners. Conducts performance audits and provides respective partner feedback along with additional training as needed to help support in partner development. Works all advanced functions within Epic and performs other duties as assigned.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Serves as A Subject Matter Expert-SME with regards to the insurance follow-up processes and the respective Patient Financial Services Follow-up role, maintaining an advanced knowledge of payor updates including Federal and State guidelines, department workflows and resources needed to resolve payor rejections and troubleshoot identified denial trends.
• Knowledgeable in the Single Billing Office for both Hospital Billing and Professional Billing environment within Epic.
• Conducts and manages all department workflow training for new hires to ensure the 90-day standards are successfully met.
• Escalates and follows-up with various Mercyhealth departments on any open and unresolved items to assure timely submissions on outstanding claims
• Monitors and works interdepartmental communication work queues to help ensure timely follow-up and resolution to department along with patient open items.
• Investigates and works identified payor trends to help present a recommended resolution to improve payment outcomes.
• Develops written workflows and job aids to help provide additional resources to Follow-Up Representatives.
• Partners with the Revenue Cycle Training department to host shadowing sessions for new partner orientations to help aid in sharing general knowledge about the role and impact it has within the revenue cycle.
• Assists with the review and approval of department adjustment requests, ensuring appropriate follow-up was completed and correct adjustment codes were selected, providing partner feedback where applicable.
• Researches and provides ongoing partner education regarding regulatory compliance and requirements for claim submission.
• Ensures accurate and timely completion of daily tasks and projects.
• Works with the supervisor to develop and maintain individual and work group statistics that measure quality and productivity.
• Performs partner audits on a regular basis to ensure quality and accuracy of partner work product
• When applicable, identifies and takes appropriate action to resolve problems to ensure that Mercyhealth obtains expected reimbursement. Brings workflow discrepancies to the attention of a supervisor or manager.
• Provides daily support to work group partners by being available to answer questions and gives direction on workload.
• On occasion, with the coordination of a supervisor, adjusts workload.
• In-depth knowledge of Revenue Cycle applications and websites.
• Serves as a backup to other leads within their team, assisting as needed.
• Special projects as assigned

EDUCATION AND EXPERIENCE

High school diploma or equivalent required. Associates degree in a business or healthcare field preferred. Five years of healthcare experience required, with emphasis in billing, insurance, collections, registration, scheduling, or customer service.

CERTIFICATION AND LICENSURE

Epic billing or HFMA CRC certification or comparable certification

Mercyhealth offers a generous total rewards package to eligible employees including, but not limited to:

* Comprehensive Benefits Package: Mercyhealth offers a retirement plan with competitive matching contribution, comprehensive medical, dental, and vision insurance options, life and disability coverage, access to flexible spending plans, and a variety of other discounted voluntary benefit options.

* Competitive Compensation: Mercyhealth offers market competitive rates of pay and participates in various shift differential and special pay incentive programs.

* Paid Time Off: Mercyhealth offers a generous paid time off plan, which increases with milestone anniversaries, to allow employees the opportunity for a great work-life balance.

* Career Advancement: Mercyhealth offers a number of educational assistance programs and career ladders to support employees in their educational journey and advancement within Mercyhealth.

* Employee Wellbeing: Mercyhealth has a focus on wellbeing for employees across the organization and offers a number of tools and resources, such as an employer-sponsored health risk assessment and a Wellbeing mobile application, to assist employees on their wellbeing journey.

* Additional Benefits: Mercyhealth employees have access to our internal and external employee assistance programs, employee-only discount packages, paid parental and caregiver leaves, on-demand pay, special payment programs for patient services, and financial education to help with retirement planning.