Post Payment Review Lead

Northside Hospital Inc. • Brookhaven, GA

19h

About The Position

The Post Payment Review Lead coordinates the work of Reimbursement Specialists and resolves complex inquiries or complaints escalated by the team. The role also performs all duties of a Reimbursement Specialist. It involves trending, reporting, and escalating issues that contribute to payment discrepancies, as well as collaborating on long-term solutions to prevent them in the future.

The position is scheduled to work from 7:00 a.m. to 3:45 p.m. Weekend and on-call work are not required.

Requirements

• Four years of experience in patient accounting or healthcare reimbursement, or an associate degree with two years of experience.
• Experience interpreting UB04 billing documents and EOB remittances against managed care contracts, and processing adjustments.
• Basic knowledge of hospital terminology applicable to patient billing.
• General knowledge of HMO/PPO contracts and credit balance.
• Good oral and written communication skills.
• Demonstrated knowledge of ten key calculators, personal computers, and computer spreadsheet programs.
• Ability to perform basic mathematical calculations.

Nice To Haves

• Prior leadership experience.
• Associate degree in Business or a related field.

Responsibilities

• Coordinate the work of Reimbursement Specialists.
• Resolve complex inquiries and complaints escalated by Reimbursement Specialists.
• Perform all duties of a Reimbursement Specialist.
• Trend, report, and escalate issues contributing to payment discrepancies.
• Collaborate on long-term solutions to prevent future payment discrepancies.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree