[Hiring] Lead PFS Medical Billing Specialist @Mosaic Life Care

Role Description

• Performs as a proxy for the department manager as needed
• Participates and coordinates productivity and quality program standards as needed
• Participates and coordinates payer meetings as needed
• Performs as a subject matter expert to caregivers for account resolutions
• Ensures and stays up to date on hospital and/or clinic compliance with all state and federal regulations and reports suspected compliance issues to the department manager
• Plans, coordinates, and implements onboarding efforts for new caregivers
• Organizes and implements initial and ongoing staff training and education in collaboration with the department leader as needed to drive departmental performance, including:
  • One-on-One training sessions
  • Group training sessions
  • Educational meetings for new and updated payer guidelines
• Assists departmental leaders in establishing, implementing and verifying adherence to controls that maintain appropriate billing and reimbursement practices
• Acts as a mentor to any caregiver within the organization
• Works regularly with all revenue cycle departments to analyze and resolve accounts
• Ensure month-end reconciliation reports are completed accurately each month
• Assists the department manager in compiling reports as needed
• Accurately bill claims
• Ensure timely filing deadlines are met for various payers
• Adequately bill claims per compliance and payer guidelines
• Collaborate with various areas of revenue cycle and the organization to ensure accurate and timely billing of claims
• Stay current on compliance and payer policies and share information with other caregivers within the organization
• Act as a mentor to caregivers in the Medical Billing Specialist I and II roles
• Participates in team activities, trainings and/or educational meetings
• Identifies trends and root causes to issues
• Escalates trends with solution proposals
• Proactively researches and understands payer issues
• Collaborates with payer representatives regarding compliant claim submissions
• Assists with special projects, audits and reports
• Provides extensive analysis and research for complex claim errors and rejections
• Identifies solutions to complex claim errors and rejections
• Projects enthusiasm and energy in all efforts

Qualifications

• H.S. Diploma - Required
• Associate's Degree - Preferred
• 4 Years - Non-clinical healthcare experience, preferably in revenue cycle - Preferred

Requirements

• Intermediate to Advanced Microsoft application skills required
• Excellent oral and written communication skills
• Excellent organization and time management skills, and ability to establish priorities effectively
• Dependable in both production and attendance
• Communicates clearly with professional etiquette with internal and external departments and customers
• Creative problem-solving skills
• Research and review payer policies, guidelines, and compliance guidelines
• Medical Terminology knowledge
• Escalate issues appropriately to leadership
• Ability to work independently and multi-task as needed
• Interacts virtually with team to stay connected and informed
• Interpersonal Skills
• Demonstrates excellent customer service skills by maintaining friendly, courteous and helpful behaviors with everyone
• Ability to operate equipment on continuous/repetitious basis such as computer, telephone, fax, calculator, and copier
• Job requires sitting mostly, walking and standing occasionally
• Ability to analyze and interpret data, explain issues thoroughly, be adaptable in daily responsibilities and flexible based on department and organizational needs
• Ability to collaborate to resolve any potential carrier claims processing issues
• Limited exposure to hazards

Benefits

• Concierge services
• Employee lounge
• Wellness programs
• Free covered parking
• Free on-site and virtual health clinics
• Additional perks designed to ensure employees feel valued