HIT Revenue Cycle Lead

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Job Description Summary:


Generate claims for submissions to patients and/or third-party payers (commercial and federal/state government sponsored programs). These claims result from products and services administered to patients from our customers. Assist with the Revenue Analyst and ensure that follow-up is being done and payer issues are being resolved. Also be able to assist or do the month-end reporting for the account.


Qualifications:


  • Desired one Year experience in revenue cycle analysis within the healthcare industry, preferably in infusion.
  • Minimum of a high school diploma or GED is required.
  • Knowledge of Windows, Word, and Excel is highly desired.
  • Excellent telephone and communication skills essential.
  • Strong analytical skills and attention to detail
  • Familiarity with healthcare IT and revenue management software.
  • Ability to work independently and part of a team.
  • Not required but desired experience with CPR+, Caretend, Weinfuse
  • The ability to use logic as a problem-solving skill and to recognize trends to improve business.


Duties and Responsibilities:


  • Assist with the continued development of existing Revenue Analysts and back up their responsibilities.


  • Maintain a smaller aging split and be able to jump on others splits as needed.


  • Submit claims to insurance companies in a timely fashion and within the individual insurance company’s timely filing period. Work with supervisor/auditor to make sure claims are being worked/billed in timely manner.


  • Meet as needed with analysts that need assistance to go over high dollar accounts, problem accounts, and/or have general questions.


  • Assist upper management with outstanding payor issues, high dollar accounts and provide a summary for month end summary.


  • Responsible for creating and maintaining spreadsheets that are shared with clients and/or managed care.


  • Work closely with other team leads (i.e., Billing Team Lead/Cash Lead) to identify and resolve outstanding payer issues.


  • Work directly with the clients on weekly calls, bi-weekly or monthly to review outstanding issues, including managed care calls.


  • Work directly with supervisor/manager providing feedback on employees that you are working directly with this includes suggested improvements, accomplishments, milestones, etc.


  • Assist with checking billing daily (This would differ by account)


  • Miscellaneous duties as assigned includes but not limited to
    • Learn new software/set up and work closely with trainer.
    • Work with upper management on specific account processes and help create and roll out to team
    • Assist with uploading and maintaining fee schedules
    • Assist with reviewing, approving and keying adjustments
    • Assist with month end – Gathering data and preparing month end summary/reports


Working Conditions:

  • Ability to sit 90% of the workday.
  • Workload may occasionally require overtime hours.
  • Workspace (remote employees)- a comfortable dedicated workspace is essential. This space must be quiet and distraction free.
  • It is necessary to have high Speed internet.

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