CRMG Billing Services Lead

Cheyenne Regional Medical Center•Warren Air Force Base, WY

15d

About The Position

A Day in the Life of a CRMG Billing Services Lead This position leads a team or group to facilitate all billing and collection activities. This position has a general understanding of all functions in the Billing Services departments to provide outstanding customer service and facilitate timely action and account completion for billing questions for any customer. Why Work at Cheyenne Regional? 403(b) with 4% employer match ANCC Magnet Hospital 21 PTO days per year (increases with tenure) Education Assistance Program Employee Sponsored Wellness Program Employee Assistance Program Loan Forgiveness Eligible Assembles issues and makes recommendations to management, assists with recurring training, prioritizes tasks, and meets with staff to identify issues. Assists with verifying process and procedures. Provides exemplary customer service while working with patients, and/or guarantors, and insurance companies concerning areas of expertise. Evaluates payor remits and denials for accuracy according to individual contracts and pursue reimbursement on accounts with general understanding of CPT, HCPCS, ICD-10 and revenue codes; composes and submits appeals to third party payers, appealing to the highest level to resolve account denial for proper reimbursement. Receives and researches patient, payor, attorney, and third-party inquiries received through incoming calls and correspondence in a timely manner by reviewing all information available including payor remits, contracts, documentation, policies and procedures, insurance laws and formulate an informative response and direct the account appropriately. Research and compile reports as required for audits and communicates to leadership and specified areas. Reviews teams assigned work queues (WQs) to ensure items are worked promptly and according to standard work. Assists in Follow Up and Call Center Research WQs as needed based on staffing. Leads a small group or team of employees as appropriate in role specific areas. Promotes and participates in LEAN practices/strategies and adheres to Cheyenne Regional Medical Center TrueCare Standards. Knowledge of federal and state billing and coding regulations Knowledge of current billing compliance regulations and issues. Knowledge of payor contracts and billing requirements Critical thinking and analysis skills Knowledge of the Revenue Cycle Ability to analyze payor denials and determine where there is a need for performance improvement. Effective verbal, written, and interpersonal communication skills. Knowledge of various computer programs, including billing system, document imaging system, and Microsoft office products, especially Excel and Word Ability to interact respectfully with diverse cultural and socio-economic populations Education (must meet all of one of the following): Associate's degree or higher and one (1) or more years of healthcare billing experience High School diploma (or equivalent from an accredited program) and two (2) or more years of healthcare billing experience Current Registered Health Information Technician (RHIT) certification and one (1) or more years of healthcare billing experience Current Medical Billing and Coding certification and one (1) or more years of healthcare billing experience Completion of a medical billing and coding certificate program and one (1) or more years of healthcare billing experience Associate's degree or higher Patient registration in an electronic health record system Experience with Epic Registered Health Information Technician (RHIT) or Certified Medical Billing and Coding through AAPC Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Requirements

Knowledge of federal and state billing and coding regulations
Knowledge of current billing compliance regulations and issues.
Knowledge of payor contracts and billing requirements
Critical thinking and analysis skills
Knowledge of the Revenue Cycle
Ability to analyze payor denials and determine where there is a need for performance improvement.
Effective verbal, written, and interpersonal communication skills.
Knowledge of various computer programs, including billing system, document imaging system, and Microsoft office products, especially Excel and Word
Ability to interact respectfully with diverse cultural and socio-economic populations
Associate's degree or higher and one (1) or more years of healthcare billing experience
High School diploma (or equivalent from an accredited program) and two (2) or more years of healthcare billing experience
Current Registered Health Information Technician (RHIT) certification and one (1) or more years of healthcare billing experience
Current Medical Billing and Coding certification and one (1) or more years of healthcare billing experience
Completion of a medical billing and coding certificate program and one (1) or more years of healthcare billing experience
Associate's degree or higher

Nice To Haves

Patient registration in an electronic health record system
Experience with Epic
Registered Health Information Technician (RHIT) or Certified Medical Billing and Coding through AAPC

Responsibilities

Assembles issues and makes recommendations to management, assists with recurring training, prioritizes tasks, and meets with staff to identify issues.
Assists with verifying process and procedures.
Provides exemplary customer service while working with patients, and/or guarantors, and insurance companies concerning areas of expertise.
Evaluates payor remits and denials for accuracy according to individual contracts and pursue reimbursement on accounts with general understanding of CPT, HCPCS, ICD-10 and revenue codes; composes and submits appeals to third party payers, appealing to the highest level to resolve account denial for proper reimbursement.
Receives and researches patient, payor, attorney, and third-party inquiries received through incoming calls and correspondence in a timely manner by reviewing all information available including payor remits, contracts, documentation, policies and procedures, insurance laws and formulate an informative response and direct the account appropriately.
Research and compile reports as required for audits and communicates to leadership and specified areas.
Reviews teams assigned work queues (WQs) to ensure items are worked promptly and according to standard work.
Assists in Follow Up and Call Center Research WQs as needed based on staffing.
Leads a small group or team of employees as appropriate in role specific areas.
Promotes and participates in LEAN practices/strategies and adheres to Cheyenne Regional Medical Center TrueCare Standards.