Job Title:
Lead Patient Representative
Cost Center:
Patient Financial Services
Job Description:
The Patient Financial Services Lead is responsible for the support of the team functions necessary to accomplishing the objective of the department. These include, but are not limited to functions under the categories of billing, insurance follow up, denials management, cash application, credit management, support services and vendor management. The Lead is responsible for training and education of new and current team members and assists the manager in monitoring production and quality statistics for staff as well as making recommendations for improving productivity/quality. Serves as a resource for team members, answering questions and resolving issues, first level of escalation prior to management intervention. Minimum Qualifications o Education o High school diploma or equivalent required. o Credentials o None Physical Demands 1. Stand and/or walk frequently. Sit frequently. 2. No lift and/or carry. 3. No push and/or pull. 4. Visual acuity and manual dexterity within normal limits. 5. Bend, stoop, and crouch occasionally 6. Reach floor to overhead occasionally. 7. Computer use frequently.
Essential Functions
1. Perform scheduled audits of billing, collections, denials, credits, cash application and vendor management as generated through HB and PB Resolute applications. Follow up as necessary with staff to ensure accuracy of data and address areas of targeted improvement.
2. Actively participates in daily huddles, one-on-ones, weekly/monthly meetings as well staff onboarding and annual evaluations.
3. Actively participates in training and orientation of new employees, development of new workflows and re-education of existing staff as needed.
4. Participates in the development, implementation and/or maintenance of all Patient Financial Services related software systems and products, including but not limited to billing clearinghouses, denials software, and payer websites and tools.
5. Meets and/or exceeds assigned key performance indicators within Patient Financial Services, including but not limited to clean claim rates, DNFB rates, AR Aging, denials reductions as well as any specified vendor performance and credits reductions.
6. Acts as the first point of escalation regarding any concerns or issues before manager intervention and serves as a point of escalation for operational issues for internal and external sites.
7. Assist in managing W/Q’s when staff are absent.
8. Actively works with NMC on opening tickets and working on enhancements to improve processes within the Patient Financial Services Dept.
9. Responsible for working collaboratively with other departments within the hospital to maintain a good relationship between departments.
10. Together with other work group leads as well as defined reps (such as vendor management and revenue integrity), works as a team to assist the department in meeting goals.
11. Compiles production statistics for daily, weekly, monthly and quarterly reports.
12. Additional duties as assigned.