PB Team Lead - Claim Edits and Follow Up

Job description

Company Description At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system. We pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, our goal is to take care of our employees. Ready to join our quest for better? Job Description ​​​​​​The Team Lead Patient Accounting reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. Responsibilities: Consistently exceed the productivity and quality standards established for the Team Lead position in resolving a high volume of phone calls, timely handling of patient concerns and correspondence, while maintaining the Patient First philosophy. Act as the first escalation point for conversations with difficult customers, customers who request a supervisor or manager, and customers with complex issues who ask for information that requires in-depth knowledge; recommend corrective services to respond to customer complaints. Assist the Patient Accounting Operational Coordinator in the management of people, processes and projects to implement the overall strategies and/or achieve the goals of the Patient Accounting department. Commitment to team development, communication and quality improvement throughout the Patient Accounting process. Responsible for providing feedback and mentoring/training for new staff and staff who are not meeting productivity standards. Responsible for education and enhancement of customer service to external and internal customers. Responsible for maintaining an up-to-date schedule of all staff and phone schedules. Attend training and seminars as assigned and approved by the Patient Accounting Operational Coordinator. Work to continually improve processes; ensure timeliness of interactions with patients to improve patient satisfaction and that staff are meeting productivity and quality metrics. Receive and direct the public, in person or by telephone, in a professional and courteous manner. Answer patient inquiries with the objective of resolving the patient issue in one call or direct inquiries to the appropriate representative or department if the issue cannot be immediately resolved. Enter appropriate documentation of all account activity. Provide clerical support to the management and supervisory staff as needed. Manage early-out vendor return accounts as outlined in the NMHC Self-Pay Collection Procedure. Coordinate communication with early-out vendor staff regarding patient accounts, concerns, and complaints as outlined in the NMHC Self-Pay Collection Procedure. Enter appropriate documentation of all new insurance information to restart the billing and follow-up cycle as appropriate. Respond to patient, payor, and employee inquiries regarding hospital and professional balances, financial assistance applications, and both hospital and clinics visits as they relate to the SBO. Seamlessly transition patient calls to and from early out vendor staff as required. Provide individual contribution to the overall team effort of achieving the department accounts receivable goal. Identify opportunities for customers, system and process improvement and submit to management. Utilize assigned menus and pathways in the hospital mainframe system and report software application problems to the appropriate supervisor. Utilize assigned menus and pathways in external software applications and report software application problems to the appropriate supervisor. Utilize assigned computer hardware and report hardware problems to the appropriate supervisor. Participate in the testing for assigned software applications, including verification of field integrity. Assist the Patient Accounting Operational Coordinator with special projects and other duties as assigned, as necessary. Qualifications Required: Two-to-four years of college, or equivalent work experience. Three-to-five years of progressive work experience in a hospital/ physician billing or SBO environment. Knowledge of HIPAA standards. Able to effectively lead a team composed of direct and indirect reporting relationships. Ability to perform mathematical calculations. Excellent communication skills when dealing with patients, families, public, co-workers, and professional offices. Intermediate knowledge of medical terminology and billing practices. Extensive experience and knowledge of PC applications, including Microsoft Office and Excel. Preferred: Two or more years of college or college degree. Call center or telephone work experience. Knowledge of Epic Systems. Four (4) years progressive work experience in a hospital/ physician billing or SBO environment. Detail-oriented, good organizational skills, and ability to be self-directed. Strong time management skills, managing multiple priorities and a heavy workload in a high-stress atmosphere. Flexibility to perform other tasks as needed in an active work environment with changing work needs. High-level problem solving, analytical, and investigational skills. Excellent internal/external customer service skills. Excellent communication skills including oral and written comprehension and expression. Additional Information Northwestern Medicine is an equal opportunity employer (disability, VETS) and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status. Background Check Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and, at times, internal transfers. If you are offered a position with us, you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check. Results are evaluated on a case-by-case basis, and we follow all local, state, and federal laws, including the Illinois Health Care Worker Background Check Act. Artificial Intelligence Disclosure Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person. Benefits We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more. Sign-on Bonus Eligibility (if sign-on bonus offered for position): Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign on bonus. Exception: New graduate internal employees seeking their first licensed clinical position at NM may be eligible depending upon the job family.