ONE CALL RESOLUTION TEAM LEAD

Premier Health•Dayton, OH

2d•Hybrid

About The Position

The One Call Resolution Team Lead (OCRTL) supports the PHP mission, vision, and values through resolution of the patient’s account balance and coordinating pre-service activities, in accordance with PHP policies and various regulatory compliance rules. The OCRTL shares the fiscal responsibility with other Revenue Cycle Departments to complete timely financial clearance on accounts, collect on accounts, reduce bad debt, advise, and subsequently obtain required information to process applications for all available financial assistance programs, including evaluating patient’s eligibility for Medicaid, state and hospital-sponsored charity care programs and other available funding sources. The OCRTL assesses and determines a plan for resolution including following cash management techniques when collecting money. This position serves as gatekeeper for managed care contracts serving as a liaison between the insurance companies and the Managed Care Department. The OCRTL understands the hospital’s financial and discounting policies by using critical thinking to provide guidance to reach the best resolution based upon the patient’s situation. This position also serves as a point of contact for any patient escalations that arise during the pre-services process including but not limited to scheduling for services, providing estimates, and or addressing patient complaints. OCRTL’s communicate via phone, MyChart, email, and in writing with patients and payers to obtain any information necessary to ensure payment of services. OCRTL’s are required to travel to and work from any Premier site outside of their hired location based on staffing and patient needs to perform each of these responsibilities. The OCRTL collaborates with other departments within the hospital and outside eligibility vendors as necessary. The OCRTL uses financial systems to document data and conducts procedures to assist the patient in filing for Medicaid and/or other public assistance programs. This position monitors and maintains departmental work queues ensuring accounts are worked efficiently for pre-services, conducts training, and provides mentoring to staff. The OCRTL must meet and maintain departmental and individualized productivity and efficiency standards and must successfully complete all required annual training and pass all competencies.

Requirements

High School completion / GED
Proficient with Windows-based computer technology, including keyboarding.
3 - 5 years of job related experience
Overall knowledge of patient registration, third party collections, verification of insurance benefits, Medicaid and other government programs, financial assistance, hospital billing and/or managed care contracts is required.
4 + years of recent financial assistance, billing, insurance verification, or self-pay accounts receivable management healthcare experience in a /medical setting or financial institution setting.
Basic knowledge of debits and credits required.
Must possess good math skills and pass a skills test which includes calculating co-pays and deductibles within 90 days from hire.
Ability to perform a variety of tasks, often changing assignments on short notice.
Must be adept at multi-tasking.
Will be required to learn and work with multiple software/hardware products to be used during the course of an average work day.
Must possess excellent verbal and listening communication skills and be able to maintain a professional demeanor in stressful situations.
Must be adept with machinery typically found in a business office environment.
Possesses mathematical aptitude to make contractual calculations and estimate patient financial obligations to achieve financial clearance.
Able to build productive relationships with all contacts.
Must be proficient in Windows-based computer technology, including keyboarding and typing at least 30 wpm.

Nice To Haves

Associates Degree preferred in related field.
Medical Terminology and coding knowledge preferred.
Experience working with the public is preferred.
Courses/workshops in compliance, medical self-pay accounts receivable management, Medicaid, medical billing preferred.
Familiarity with statutes and regulations regarding self-pay collections practices and financial assistance is preferred.
Associates degree in Healthcare or Business can be substituted for two years of experience.
Minimally one-year experience in a hospital, medical office/clinic, or insurance company.
Overall knowledge of third party collections, registration, billing and contracts is preferred.

Responsibilities

Resolution of the patient’s account balance and coordinating pre-service activities.
Complete timely financial clearance on accounts.
Collect on accounts and reduce bad debt.
Advise and obtain required information to process applications for all available financial assistance programs.
Evaluate patient’s eligibility for Medicaid, state and hospital-sponsored charity care programs and other available funding sources.
Assess and determine a plan for resolution including following cash management techniques when collecting money.
Serve as gatekeeper for managed care contracts serving as a liaison between the insurance companies and the Managed Care Department.
Provide guidance to reach the best resolution based upon the patient’s situation.
Serve as a point of contact for any patient escalations that arise during the pre-services process including but not limited to scheduling for services, providing estimates, and or addressing patient complaints.
Communicate via phone, MyChart, email, and in writing with patients and payers to obtain any information necessary to ensure payment of services.
Travel to and work from any Premier site outside of their hired location based on staffing and patient needs.
Collaborate with other departments within the hospital and outside eligibility vendors as necessary.
Use financial systems to document data and conduct procedures to assist the patient in filing for Medicaid and/or other public assistance programs.
Monitor and maintain departmental work queues ensuring accounts are worked efficiently for pre-services.
Conduct training and provide mentoring to staff.
Meet and maintain departmental and individualized productivity and efficiency standards.
Successfully complete all required annual training and pass all competencies.