General Summary of Position Ready for the next step in your Patient Accounting career? MedStar Health's Patient Financial Services team has an opening for a TEAM LEADER to join our Account Resolution Division (ARD). The ARD Team is responsible for handling all Medicare Exhaust Claims, COB denials; and High dollar accounts exceeding $100K account charge at the time of billing for Maryland facilities and $500K reimbursement for DC facilities.
Full time, HYBRID schedule, working 4 days a week remotely and only 1 day in the office. Position does require on-site training (up to the first 90 days of employment) in our business office located in Nottingham, Maryland. Job Summary: Provides guidance and assists staff with review and analysis of various reports in assigned area. In cooperation with Supervisor, identifies and analyzes errors to determine action needed for performance improvement. In conjunction with level II Insurance Specialists, assists in researching and addressing administrative customer service issues. Works with all team members to resolve multiple primary and secondary billing, collection, customer service issues with payers and patients.
Primary Responsibilities • Researches and analyzes complex and escalated accounts to identify and complete appropriate steps needed for resolution including, but not limited to, the research and resolution of Medicare Exhaust, Coordination of Benefit conflicts, Recovery Audits, and MSP Verification. Recognizes, documents and communicates account and payer trends. Works in collaboration with all teams, payers and patients, utilizing resources to resolve multiple primary and secondary billing, collections, and customer service issues. • Maintains daily performance benchmarks pertaining to follow-up. Maintains departmental QA standards within standard error rate. • Processes and completes the daily billing of paper claims including timely communication back to the Billing Team as appropriate.
Qualifications: - High School Diploma or GED required
- Associate's degree in healthcare Preferred or courses in Accounting, Finance and Healthcare Administration preferred
- 1-2 years' experience in patient accounting in a hospital-based department (systems, billing, medical records, registration, finance) required
- Detailed working knowledge and demonstrated proficiency in the major (Medicare, Medicaid and Blue Cross) payer's application billing and/or collection process, with particular focus on billing specifications and contractual arrangements and/or multiple payer's insurance verification and pre-certification guidelines.
- Ability to resolve complex payer issues to completion, training individuals in the billing and collection processes.
- Excellent communication and interpersonal skills.
- Excellent organizational skills to manage multiple tasks in a timely manner.
- Proficient use of hospital registration and/or billing systems, and Microsoft Word and Excel software applications.
- One of the following certifications required within 1 year of hire date:
- Certified Revenue Cycle Specialist - CRCSI
- Cert Revenue Cycle Rep - CRCR
- Cert Revenue Cycle Prof-Instit - CRCP
- Cert Revenue Cycle Executive - CRCE
- Certified Compliance Technician- CCT
- Certified Revenue Integrity Professional- CRIP
- CHAM - Certified Healthcare Access Manager
- CHAA - Certified Healthcare Access Associate
- Hospital Presumptive Eligibility- HPE
- Cert Healthcare Fin Prof - CHFP
\r Why MedStar Health? At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered. We live up to this promise through: \r
\r- Strong emphasis on teamwork-our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
\r- Strategic focus on equity, inclusion, & diversity-we are committed to equity for all people and communities. We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
\r- Comprehensive total rewards package-including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
\r- More career opportunities closer to home-as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.
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\r About MedStar Health MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.