Lead, MediCare - Patient Business Services

City of Hope•Irwindale, CA

About The Position

Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today. Position Summary: This position will have multiple responsibilities that include monitoring staff productivity reports, assisting collectors with problem accounts for payment resolution. When necessary, will assist the patient with alternative arrangements for payment resolution. This position will also be responsible for maintaining and preparing collection records and reports for management. The Lead will be required to provide coverage for long and shot term absences of billing and collection staff, if needed. Also, the Lead will monitor outside collection vendor activity including the reconciliation of their A/R. The lead is also responsible for identifying common billing errors with the goal of ensuring billing quality. The Lead will also be responsible for approving account write-offs per approved policy guidelines. The lead must be knowledgeable in all PBS systems, such as: CIRIUS, MDX, PROVIDER ADVANTAGE, QMS, DDE, MEDSTAT AND CLINICAL TRIALS SYSTEM. This position will need to be knowledgeable with respect to all major third-party payer contracts and assist collection staff with contract term interpretation. The lead will be point person in providing training and answering various questions posed by management and the billing and collection staff. The lead will also be responsible for other various reports and monitoring, as assigned by management. As a successful candidate, you will: Demonstrates ability to lead and direct a team of collectors responsible for billing and follow up with all third party payers and their entities as related to Hospital claims. Demonstrates ability to monitor adjustments (credits, debit, refunds) inventory ensuring action taken is timely and correct. Demonstrates the ability to recognize and deal with priorities in order to complete work in a timely manner. Demonstrates ability to monitor team of billers, collectors for productivity, accuracy, timely follow-up activity and assistance with technical and procedural issues. Ability to assist the Supervisor in various tasks, i.e. system training, new policy and procedure, reimbursement information, etc. Analyzes aged and problem accounts and determines when accounts are uncollectible. Randomly audit accounts for accuracy prior to approving write offs. Monitors staff and outside agencies for uncollectible claims to assure uncollectible claims are dealt with in a timely manner. Maintains various records of account activity for staff and outside agencies, as assigned by management.

Requirements

High School or equivalent
Experience may substitute for minimum education requirements
Three to five years in related field and/or areas
knowledgeable in all PBS systems, such as: CIRIUS, MDX, PROVIDER ADVANTAGE, QMS, DDE, MEDSTAT AND CLINICAL TRIALS SYSTEM
knowledgeable with respect to all major third-party payer contracts

Responsibilities

monitoring staff productivity reports
assisting collectors with problem accounts for payment resolution
assisting the patient with alternative arrangements for payment resolution
maintaining and preparing collection records and reports for management
provide coverage for long and shot term absences of billing and collection staff, if needed
monitor outside collection vendor activity including the reconciliation of their A/R
identifying common billing errors with the goal of ensuring billing quality
approving account write-offs per approved policy guidelines
assisting collection staff with contract term interpretation
providing training and answering various questions posed by management and the billing and collection staff
responsible for other various reports and monitoring, as assigned by management
lead and direct a team of collectors responsible for billing and follow up with all third party payers and their entities as related to Hospital claims
monitor adjustments (credits, debit, refunds) inventory ensuring action taken is timely and correct
monitor team of billers, collectors for productivity, accuracy, timely follow-up activity and assistance with technical and procedural issues
assist the Supervisor in various tasks, i.e. system training, new policy and procedure, reimbursement information, etc.
analyzing aged and problem accounts and determines when accounts are uncollectible
randomly audit accounts for accuracy prior to approving write offs
monitor staff and outside agencies for uncollectible claims to assure uncollectible claims are dealt with in a timely manner
maintain various records of account activity for staff and outside agencies, as assigned by management