Team Lead - Healthcare - Hospital PFS

Team Lead - Hospital Claims

The Team Lead - Hospital Claims is responsible for supervising and coordinating the daily operations and activities of the assigned team of patient account representatives. This role ensures the efficient handling of patient accounts while maintaining quality assurance standards.

The individual is to provide support in developing, implementing, managing, and meeting or exceeding the operational goals of our clients and company. The Team Lead will and may work closely with their team, project supervisors, operations managers, and the client to work on opportunities with new and emerging approaches to our clients' business processes. This position will follow and ensure that client and company policies and procedures are followed and will also perform all job-related duties as assigned.

This position is classified under a hybrid schedule consisting of working two days in the San Marcos, CA office and three days working from home.

Responsibilities:

• Strong hospital claims A/R & billing follow-up
• Mentoring of fellow team members when needed
• Supporting of staff/supervisor to be successful and work as a team
• Manage day-to-day problem solving and a point of contact for team questions
• Quality assurance reviews, feedback, and other trainings as necessary
• Sending of official correspondence (e-mails) to team members, client, and providers
• Ability to work with other leads to develop policies and procedures, as needed
• Provide feedback for mid-year and year end employee reviews to leadership
• Organizing team building exercises
• Create, distribute, and monitor team members understanding of work-related job-aides
• Monitor and ensure compliance with company and client standards
• Strong understanding of all software/systems used
• Identify, validate, and report project trends/issues
• Updating of spreadsheets, monitoring outstanding items for each client, and providing updates to leadership, client, and team
• All job-related duties as assigned

Qualifications:

• High School Diploma/GED and 8 years of relevant experience.
• Relevant experience coming from the following, healthcare payor, provider, revenue cycle, business operations, or professional services environment.

Nice To Have:

• Hospital claims A/R background
• Demonstrated proficiency in relevant revenue cycle processes with high production and quality standards
• Verbal and written communication skills to effectively communicate with staff and client
• Demonstrated proficiency interpreting relevant coding systems including, but not limited to, CPT and HCPCS and ICD-10 in a fast-paced environment.
• Proficiency researching billing guidelines
• Providing training and mentoring to team members
• Act as a role model for team, office, and company

The annual salary range for this position is $65,000.00-$108,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

Guidehouse is an Equal Opportunity EmployerProtected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.