Scheduling/Billing Specialist Lead (Full Time)

• Area of Interest: Patient Services
• FTE/Hours per pay period: 1.0
• Department: Rehab Administration
• Shift: Monday thru Friday Days
• Job ID: 164269
  
  

Overview

Assists the therapy business services leadership in the operation and organization of the outpatient therapy office areas in addition to the assigned scheduling and financial specialist duties: reception, billing, scheduling, charge and data entry, insurance pre-authorization, verification and benefit coordination, report preparation, filing, record keeping and other duties for one or more areas within Physical Medicine and Rehabilitation. Responsibilities include ensuring adequate staffing on a daily basis for all clinics, training and maintaining competencies for office staff, and working insurance denials. Adheres to detail in the performance of rehabilitation procedures, solving practical problems, resolving conflict, and implementing constructive change. Serves as a member of the rehabilitation team and supports the direction and accomplishment of hospital short and long-range goals.

Responsibilities

Non-Clinical Excellence

Scheduling/receiving/greeting:

• Receives patients and visitors and answers telephone; screens calls and callers, referring them to the appropriate person.
• Creates a welcoming environment for person’s served. Effectively manages positive relationships with referral sources and other members of the team.
• Schedules all patient appointments.
• Coordinates all modifications to patient schedules, including reschedules, cancellations, no-shows and discharges.
• Manages providers calendars.
  
  

Billing/insurance/counseling:

• Verifies insurance eligibility and insurance coverage for assigned department(s) via phone or internet. Contacts patients prior to first appointment and counsel’s patient on coverage. If unable to contact patient prior to first appointment, counsels them when they arrive for first appointment. Documents in account notes in EPIC.
• Gathers billing information for patients with worker’s comp insurance (employer demographics, responsible billing party, billing address) and coordinates authorization for services.
• Manages and coordinates pre-authorizations for services as needed. Sends requested documentation to third party payers for prior authorization and reauthorization of patient visits.
• Coordinates Price-line requests for estimate of cost for the patient.
• Counsels patients on process for estimates of their payment for therapy, prompt pay, and financial assistance applications.
  
  

Accurate billing/collections/denials:

• Reconciles daily patient attendance and charges posted with revenue/usage reports.
• Responds to patient’s questions regarding their account and ensures solutions to patient billing, complaints or concerns.
• Demonstrates ability to effectively manage details by accurately completing registration/referrals, maintaining medical records, and charge correction.
• Collects payment as needed
• Monitors and completes accounts on multiple work queues in EPIC, including referrals and denials.
• Problem solves, analyzes and collaborates with patient, therapist, Central Billing Office, Revenue Cycle department, and insurance companies to identify and resolve billing and denial issues, including sending appeals and trouble- shooting and correcting claim or account errors.
• Documents denials and billing issues to identify processes that need improvement in order to maximize efficiency and ensure proper payment within the department.
  
  

Daily and/or weekly duties:

• Creates and modifies documents using word processing and spreadsheet computer programs.
• Maintains designated filing and record keeping systems. Assists with preparation of reports, graphs, and statistical information.
• Orders supplies for department.
• Serves as payroll timekeeper for assigned departments.
• Performs other related secretarial and clerical functions as requested.
  
  

Other Essential Duties And Job Responsibilities

• Responsible for maintaining adequate coverage of office personnel at all outpatient clinics on a day to day basis
• Trains office staff to assist in all appropriate duties
• Keeps current with changes in hospital office procedures and shares with scheduling staff
• Provides leadership, training and guidance to office staff
• Assures accurate daily and monthly billing
  
  

Qualifications

• Must be at least a high school graduate
• Prior administrative experience in healthcare
• Writes, reads, comprehends and speaks fluent English
• Multicultural sensitivity
• Microsoft Office and Outlook – basic computer skills
• Customer/patient focused
• Critical thinking skills using independent judgment in making decisions
• High organizational skills
• Ability to multi-task
• High attention to detail
• Use of usual and customary equipment used to perform essential functions of the position