PFS Team Lead

Catholic Health•Melville, NY

4d•$30 - $43

About The Position

Catholic Health is one of Long Island’s finest health and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health, our primary focus is the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes – to every patient, every time. We are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace! Under the direction of the Supervisor, the Patient Financial Services Department Team Lead is a resource available to the staff as well as a support to the Supervisor. The lead is responsible to conduct staff quality reviews, identify and assist with training needs, review and escalate high-dollar cases, and prepare the team for discussions with payer.

Requirements

High School diploma or equivalent required.
2 +years' experience in Hospital insurance billing and/ or follow up, knowledge of third party insurance in regards to plan types (HMO/PPO/POS and Indemnity) including payment posting, required
Strong data entry skills; ability to input and compile high volume of information
Proficient 10 key skills, subject to testing
Attention to detail – ability to maintain speed while upholding accuracy
Knowledge of CPT, ICD-9 or medical terminology preferred
Ability to perform analysis and discuss with Supervisor/ Manager
Proficient in Microsoft Office: Word and Excel, subject to testing

Responsibilities

Identify staff training needs and assist with delivery of various training programs
Notify Supervisor of existing policies and procedures that require updating and new processes that require documentation and implementation.
Create, update, and preparing reports and spreadsheets for assigned payers.
Transfer accounts in workstation as needed for alternative follow up measures
Evaluate and resolve high dollar accounts timely to prevent financial losses. Escalate payer issues as appropriate
Identify and communicate root causes for failed bills/ claims. Assist the Supervisor to resolve systemic and operational issues
Address and/ or resolve credit balances as assigned according to department policy
Review and approve staff recommendations for write off, in accordance with the Departmental policy
Meet and/ or exceed weekly productivity and quality standards for assigned worklists/ work queues
Conduct quality reviews for staff in accordance with Departmental policy