LEAD MEDICAL BILLING SPEC-REMOTE

Team Leader Responsibilities and Duties

The Medical Billing Specialist Team Leader is responsible for the entry of all data processed through the Accounts Receivable Office; including all system documentation, charges, payments (lockbox & mail), adjustment and other transactions. The Medical Billing Specialist performs daily, monthly and special system processing requirements (i.e. batch posting and balancing).

1) Coding/Charge Review

• Ensure Team Members are completing tasks/job functions timely
• Coders receive charges from centers
• Coders code charges within 1 day/24 hours of receipt of charge from centers
• Coded charges/charge slips to Charge Entry team same day as coding completed
• Charge Review team defers any charge not accepted with notes indicating why the charge is deferred
• Work with CBO AR Manager to develop a common (all CBO centers) way for each center to report charges (surgery, hospital rounding, etc.)
• Work with CBO AR Manager/CBO Administrator to implement coding education for CBO staff

2) Customer Service

• Faxes, mail and courier items distributed immediately (utilizing mail boxes at front door rather than interrupting staff at work stations)
• Charges received via fax are batched using a Batch cover sheet
• Batch is logged into the Extraction Log on the CBO Shred Drive
• Batch is delivered to the correct coding staff member's mailbox
• Hardcopy and Secondary Claims printed daily
• Verify BWC claim/info is correctly processed

3) Charge Entry

• Ensure team members are completing tasks/job functions timely
• Manual charge entry batches are being received promptly from coding
• Charges are keyed into Epic within 1 day/24 hours of receiving from Coding
• Extraction Log is completed once batch is keyed into Epic
• Determine that work/charges to be keyed are evenly distributed to each team member
• Each team member is expected to inform team leader when they are behind
• Check/Spot check team members' work for errors

4) Payment Posting

• Ensure team members are completing tasks/job functions timely and according to guidelines
• Payments are posted within 24 hours of deposit to bank
• Payments batches are balanced to EPIC daily, utilizing the PB Payment Activities report
• Spreadsheets are balanced to bank every Monday; if team member is off on Monday, balancing to be performed the day before PTO begins
• Reconciliation items from previous month are posted prior to beginning current month's payment posting
• Verify that team members are saving their work to the CBO shared drive
• Lockboxes- Daily
• Bank balancing spreadsheet- Weekly
• Spreadsheets- As updated
• Check/Spot check team members' work for errors
• Perform audits as requested by CBO AR Manager/CBO Administrator and randomly (determine if payment posted has difficulty with balancing and audit frequently)
• Work with ERA Claims Specialist to resolve missing ERAs for entire team
• Verify that ERAs are posted using Check Member not just deposit amount

5) Follow Up

• Ensure team members are completing tasks/job functions timely and according to guidelines
• WQs are current according to guidelines
• Credit WQs are being worked at least one hour per day
• ROA payments are distributed within 24 hours of center collecting payment
• Check /Spot check team members' work for errors
• Work with CBO AR Manager/CBO Administrator to redistribute responsibilities to accommodate new staff member and to ensure work is evenly distributed
• Verify that information is being deferred correctly and all encounters that are deferred have notes indicating why it is deferred

6) All Team Functions

• Report an updates, concerns, issues during weekly Team Lead meetings
• Answer questions from team members and center staff
• Educate/Inform staff regarding changes, updates, etc
• Monitor team members use of work time to handle personal business
• Socializing with co-workers
• Personal phone calls
• Communicate Roadblocks/Issues to CBO AR Manager
• Ensure consistency among staff, workflow, etc
• Cross Train/ "Buddy Billers"
• Other duties as assigned by CBO AR Managers/CBO Administrator

Qualifications

1. High School diploma or GED

2. Three to five years previous healthcare billing, collections experience, and/or managed care experience preferred.

3. Knowledgeable about third party billing regulations and CPT.4/ICD.9/10 coding

4. Routine CRT/data entry skills

5. Knowledge of spreadsheet applications

6. Proven record of dependability

7. Strong communication and decision-making skills