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Patient Financial Services Representative Lead - Remote

Employer
Fairview Health Services
Location
Saint Paul
Salary
Competitive

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Overview:

This team lead position is responsible for supporting management in leading a team in analyzing and resolving claims with billing, follow up and denials in a timely manner. The team lead is responsible for day to day support of the teams tasks, training needs, identifying trends with possible solutions, testing, documenting and training new system functionality, training of new hires while maintaining current knowledge of payor policies/guidelines. This position will work with other departmentsthroughout the organization on process improvement, participate in operational meetings including but not limited representing the team and trends presenting claim processing issues. Strong knowledge of payor requirements in Commercial payors, Preferred One, and Aetna is preferred.

NOTE: This is aREMOTE position. Fairview will provide equipment to include computer, keyboard, mouse, 2 monitor, but high speed internet is required to be available.

Responsibilities/Job Description:
  • Monitors accounts for timely follow-up and prompt resolution following payor guidelines.
  • Supports the team in day to day responsibilities and inquires.
  • Assists in continuously improving outstanding A/R while minimizing controllable loss categories (i.e. Timely filing).
  • Ensures incoming inquiries are processed timely.
  • Monitors and ensures correspondence is processed timely.
  • Ensures that all written responses are clearly and professionally communicated.
  • Performs staff quality reviews, identifying training needs while communicating with management of on-going staff billing, follow up and denial concerns.
  • Working withpatient accounts, resolving insurance within payor guidelines.
  • Understanding, verifying insurance coverage, updating insurance coverage and claim submission as needed.
  • Reviewing payor remits to determine how to appropriately resolve issues that arise.
  • Contacting payors as needed to allow resolution including attending payor operation meeting to represent payor/provider ongoing claims/payment processing concerns.
  • Monitors WQ volumes and aged accounts.
  • Seeks process improvement/efficiencies.
  • Update and maintain processes for the Commercial, Preferred One and Aetna Team as well as the HB Billing Team.
  • Train new hires and ongoing training for the team as needed.
  • Perform testing, documenting and training of new system functionality.
  • Identify trends and system breaks with examples and possible solutions.
  • Work with leadership by attending meetings and problem-solvingas needed.
  • Knowledge of professional and facility billing, claim processing, follow up and denials.
Qualifications:

Required:

  • 4 or more years in an office clerical setting, of which 3 years experience in a hospital or clinic business office processing medical claims and overpayment resolution
  • Strong knowledge of all major insurance healthcare plans
  • 2 years Epic experience
  • 1 year in a team lead role or similar such as training, process improvement or being a point person knowledge expert
  • Fluent in Windows Applications

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