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Billing Remit and Patient Escalation Resolution Manager (Georgetown, TX)

Company: Lone Star Circle of Care
Location: Georgetown
Posted on: June 9, 2021

Job Description:

The Billing Remit and Patient Escalation Resolution Manager is responsible for assisting in implementing the day to day functions of the posting and escalation teams. In this position the Billing Remit and Patient Escalation Resolution Manager will oversee and streamline billing and collection processes including the accurate posting and balancing of both insurance and patient payments. This position is highly visible and requires a strong leader with the ability to prioritize, plan and direct staff. In this position the Billing Remit and Patient Escalation Resolution Manager will oversee the patient escalations process including the oversite of Billing Liaisons. The Billing Remit and Patient Escalation Resolution Manager will handle patient escalations that require manager intervention and will at times be the main point of contact between patients and billing/clinical staff. Lone Star Circle of Care prides itself on customer relations and this position requires excellent communication skills and the ability to problem solve under pressure. Requires strong managerial, leadership, and business office skills, including critical thinking and the ability to produce and present detailed billing activity reports. This position is responsible for guidance and training to both billing and clinic staff, such as assisting with questions or problems related to the revenue cycle. In addition will provide training to new staff and re-education to current staff as needed. The Billing Remit and Patient Escalation Resolution Manager is expected to conduct business at the level of professionalism and discretionary wisdom equal to all Management Staff.


Daily Duties:

  • Manage and streamline billing and collection processes, assuring timely collection of revenue
  • Management of assigned staff as follows;
    • Interview with the Director of Billing and help make decisions regarding the hiring of Billing Payment staff
    • Training or coordination of training for staff
    • Assure acceptable levels and quality of staff assignments
    • Review staff progress, counseling if necessary and conduct evaluations per policy
    • Schedule and approve time off through ExponentHR
  • Analyze daily, weekly, and monthly reports as associated to department productivity and areas in need of improvement
  • Create, update, and implement Policies and Procedures related to LSCC Billing functions
  • Work closely with EDI Manager to assure contracts are updated for easy of payment posting
  • Patient Collections oversight including collection agency relations
  • Reporting patient payments received by LSCC on the Collection Agency portal daily
  • Entering patient payments made directly to the Collection Agency into the Billing System and reconciling the patients account including adding notes and changing to the appropriate status (None, Bad Debt, Bad Debt Hold)
  • Maintaining Bankruptcy documentation and applying bankruptcy adjustments in the billing system including notating the patients account monthly
  • Assist with the creation and implementation of billing projects as needed
  • Oversee the daily workload of Billing Payment Specialist to ensure assignments are appropriately allocated, ensuring timely and accurate posting and balancing to the daily cash receipts as provided by the LSCC accounting department
  • May review and approve patient and insurance credits
  • Assist clinical staff with site payment questions, corrections and batch posting issues
  • Assist in the management of ERA/EFT (Electronic Remittance Advice/Electronic Funds Transfer) process and associated electronic reason code maintenance
  • Oversee patient escalations and acts as the main point of contact for the Billing Liaison(s)
  • Discusses and addresses patient account concerns
  • Organize, maintain and report on Billing Escalations Spreadsheets
  • Close out the month’s insurance and patient payments by ensuring all payments are posted and balanced within the current month
  • Pulling/scanning/maintaining all paper EOB’s regardless of payment or denial and uploading them to RHS daily
  • Ability to post insurance (medical, dental, vision or pharmacy) payments/denials as needed
  • Assist in applying Month End Write Off Adjustments as assigned
  • Oversees NextGen portal emails ensuring they are responded to within 2 business days
  • Works organizational reports as assigned
  • Ability to work extra hours at month end (last business days of current month, first business day of new month) to ensure a timely close
  • Works assignments with both accuracy and efficiency to reduce errors in all areas related to encounters within the NextGen billing system including but not limited to (adjustments, balance control, refunds, reading balances/credits)
  • Organize and distribute mail daily
  • All other duties and special projects as assigned

 

Customer Service:

  • Main point of contact, responsible for taking escalated patient grievance phone calls when the patient requests to speak to a manager
  • Discusses and addresses patient account concerns
  • Responding to patient escalations timely and with professionalism utilizing AIDET and LOC skills
  • Resolve escalated complaints within LSCC's policies
  • Responding to patient portal emails within 2 days of receipt

 

Training:

  • Responsible for training and re-education of departmental staff as instructed by Director of Billing or EDI Manager
  • Provides guidance to departmental staff in identifying and resolving issues or errors related to payment entry.
  • Provide training to new staff on NextGen including but not limited to (how to maneuver, how to read patient account balances, how to post payments/adjustments following payer specific guidelines, how to balance a day utilizing the DDS, how to respond to Billing/Clinic emails, how to distribute mail, how to access payer specific websites to pull EOB’s and how to upload ERA’s to the Clearinghouse).
  • Will provide training to others outside departmental staff on billing payment procedures and practices

REQUIRED EXPERIENCE, EDUCATION, AND LICENSE:

  • Minimum of a High School diploma or GED
  • Minimum of three (3) years of medical billing and payment posting experience
  • Ability to work extra hours at month end (last business days of current month, first business day of new month) to ensure a timely close
  • Prior experience with an electronic medical records system required

PREFERRED EXPERIENCE, EDUCATION, AND LICENSE:

  • Minimum of two (2) years management experience in a medical billing office
  • Previous customer support experience
  • Certified Coder preferred
  • Excellent computer skills and the ability to learn computer programs efficiently
  • Proficiency in MS Office Suite 9Word, Excel, and Outlook)
  • Bilingual English/Spanish language skills are a definite plus

Keywords: Lone Star Circle of Care, Georgetown , Billing Remit and Patient Escalation Resolution Manager (Georgetown, TX), Other , Georgetown, Texas

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