RCM Team Lead

Job Summary

Responsible to know and facilitate specific accounts and their unique attributes in order to successfully provide customized RCM for each account. This is a dual position with its own workload along with oversight to train, audit and monitor the group for accurate procedures and turnaround. Ensure workflow, including collecting payments stays current and on track with regards to insurance carriers, patients, clients and internal interactions. Supports the overall Operations and Client Services by efficiently and effectively providing and reviewing account data needed for the Revenue Cycle process and delivering results.

Essential Functions / Major Job Responsibilities

• Strong customer service skills for client satisfaction, health of client AR and guidance for RCM team members
• Answers client calls; prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally.
• Acts as initial point person for team regarding technical work questions/processes/procedures to provide training/guidance.
• Escalates issues to RCM Management related to clients and staff.
• Trains individuals on systems and workflow in order to ensure protocols are followed.
• Reviews and works all unpaid and denied insurance correspondence, both phone appeals and written appeals; confirm all patient demographics and insurance is current and up to date.
• Runs, reviews and works unpaid patient balance reports for payment by reading current notes and place for past due letters and phone calls.
• Prepares insurance/patient correspondence for coworkers by reviewing and batching for further attention and review.
• Prepares and sends uncollected patient payments to collections by writing up forms for the doctors to review.
• Reviews and works insurance and patient over payments, prepare refund request and send to doctors office.
• Answers phone calls from insurances and patients.
• Organizes, identifies and improves workflow with team members/Management through daily and weekly productivity reports and reports challenges and concerns and requests need for assistance to RCM Management.
• Ability to perform the duties of the Payment Entry Specialist, Charge Entry Specialist, AR Specialist and RCM Specialist roles.
• Keeps manager informed of progress, achievements and issues; assist staff with processes, information and workload.
• Achieve goals set by management and compliance requirements.
• Follows, and models adherence to all policies, procedures and processes.
• Other duties as assigned.

Knowledge, Skills and Abilities

• CPT coding
• ICD10 coding
• Medical terminology
• Laserfiche
• MS Access
• PowerPoint
• NextGen
• Allscripts
• Epic

Disclaimer: This job posting and location has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.