Enrollment and Billing Team Lead

PacificSource•Springfield, OR

44d

About The Position

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. Supervise and provide guidance to the Government Enrollment and Billing team regarding company and department policies, procedures and workflow. Set goals and implement strategies to ensure internal processes are current and metrics are met. Coach team members to improve individual performance and develop teamwork.

Requirements

Minimum of four years administrative experience in the health care industry, including two years in enrollment and billing in insurance.
Associates degree or equivalent combination of experience and education.
Effective written and oral communication.
Ability to read and communicate policy and contract language.
Demonstrated time management, critical thinking and problem solving skills.
Ability to understand and interpret Federal and State regulations.
Advanced proficiency in Microsoft Office Applications. Excel skills should include formulas, sorts, filters, VLOOKUP, IF statements, etc.
Requires the ability to clearly articulate problem statements, collect data and establish facts.
Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization

Nice To Haves

Supervisory experience preferred.

Responsibilities

Maintain broad knowledge of all job positions assigned to team lead and provide supervision, training, evaluation and leadership to assigned staff.
Evaluate performance of team members. Analyze results of performance reports to determine staffing and training needs related to department goals. Provide feedback, including regular one-on-one meetings with direct reports. Conduct and submit performance evaluations on a timely basis.
Have a thorough understanding and use of the eligibility and member billing operation systems (EAM and EMS). Maintain workload in these specialty areas.
Provide and/ or oversee training and orientation of new hires. Develop programs to assure ongoing training and coaching to new and current membership staff.
Understand all applicable CMS and HPMS regulations and have the ability to educate internal and external customers. Investigate and settle issues within contract guidelines as needed. Relay information for dispute resolution to appropriate departments and personnel.
Understand all applicable OHA and OAR regulations and have the ability to educate internal and external customers.
Ensure all direct reports understand processes from end-to-end and assist with gaps as needed.
Assist with answering inquiries from members as well as conduct auditing of member accounts, verifying the validity of any past-due accounts and the delinquent letter process to Medicare members.
Ensure that all member-billing issues are submitted to business partners/vendors.
Coordinate business activities by maintaining collaborative partnerships with key departments.
Serve on various interoffice committees. Document and report any pertinent communication back to the manger, team or other.
Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees.
Provide feedback, including regular one-on-ones and performance evaluations, for direct reports.
Assist with process improvement and work with other departments to improve interdepartmental processes.
Utilize lean methodologies for continuous improvement opportunities. Use visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities.
Assist the manager with daily operations including the development, analysis and implementation of policies and procedures, training, reporting and recognition programs.
Actively participate as a key team member while creating and supporting a high-quality work environment to encourage a high performance.
Provide backup for any of the department tasks that may become backlogged, have compliance risks or have other reasons for being unworkable by staff.
Meet department and company performance and attendance expectations.
Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
Support and participate in continuous improvement initiatives.
Maintain professional, service oriented relationships.
Ability to judge severity of problems and the need to escalate to management or employ external services.
Perform other duties as assigned.