Patient Financial Services, Team Lead

Stony Brook University•Southampton, NY

11d

About The Position

Under the direction of the Assistant Director and the Assistant VP of Revenue Cycle, the Patient Financial Services (PFS), Team Lead is responsible for managing staff assignments and providing excellent leadership to staff members. The PFS Team Lead will assist with the management of the claim scrubber and electronic billing system to submit and rebill corrected claims as needed. The PFS Team Lead will be responsible for managing the Accounts Receivables as well as understanding managed care contracts and governmental updates. The PFS Team Lead will provide training, support and feedback to staff. Participate in Revenue Cycle Committee meetings, initiatives and projects as directed.

Requirements

High School diploma or equivalent required.
5+ years prior healthcare billing experience and knowledge of CPT, ICD-10, medical terminology required.
Knowledge of Word and Excel applications.
Must be able to adapt to system changes, manage heavy call volume, be a self-starter, organized, detail oriented.
Bilingual speaking is a plus.

Nice To Haves

College degree and or certifications in billing and coding preferred.

Responsibilities

Manages Accounts Receivables.
Sets-up access to systems and payer portals.
Must be able to interpret third party coverage and contract reimbursement.
Reviews, documents, and communicates all processes related to insurance and patient billing, follow up, credits denials, and appeals.
Ensures accounts are billed and followed accurately, timely, and in a compliant manner.
Processes and works explanation of benefits related to claims adjudication.
Keeps abreast of all billing and reimbursement regulations and standards to ensure compliance with any published or anticipated changes issued by governmental agencies and/or third-party payers.
Meets regularly with staff to provide support and feedback.
Shares knowledge with staff through verbal and prepared written communication.
Assists with staff training, creating educational content and job aides.
Demonstrates effective communication and teamwork by fostering a collaborative environment and promoting positive working relationships across the Revenue Cycle team and other departments.
Assists with payment review and denials management.
Addresses and/or resolves credit balances.
Monitors staff work queues and assignments.
Monitors staff, including performance, schedules and overtime.
Participates in process improvement initiatives.
Participates with audits both internal and external.
Assists with management of vendor/business partners.