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BILLING TEAM LEADER
SGMC Valdosta, GA
$58k-79k (estimate)
Full Time | Hospital 1 Month Ago
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SGMC is Hiring a BILLING TEAM LEADER Near Valdosta, GA

    • The Revenue Cycle Medical Group Billing Team Lead’s primary role is to act as a lead, coordinating the work of billing specialists. Must be able to perform all duties of the Insurance Billing Specialist job. This position is responsible for assisting in the leading and planning of the billing operations for the Revenue Cycle department. The individual is responsible for assisting in the designing, implementing and training of billing policies and procedures as well as streamlining effective billing processes across multiple markets. Provides training to new and existing staff members as instructed by director/manager. Routinely audit and monitor staff accuracy, and productivity. Reports staff’s progress, deficiencies, and training needs to management. Assist team members with their questions, helps with problems, and oversee team quality and efficiency. Communicates deadlines to billing staff. Ensures staff complete all assigned tasks in a timely manner and that all tools and resources to perform tasks are readily available and if not communicate to manager. Coordinates with manager/director to prioritize assignments based on current issues and business needs. Expected to work cooperatively as a team leader with all of the physician group, hospital and management associates. This individual will be expected to review work queues, and analytical reports to determine the most appropriate use of resources to effectively manage the Accounts Receivables.
  • KNOWLEDGE, SKILLS & ABILITIES
    • Associates degree in related field (Accounting, Business, or Finance) or equivalent is preferred however; experience with advanced knowledge of the healthcare industry, including three years of progressively responsible work experience in professional billing is comparable.
    • Certified Patient Account Representative (CPAR) highly desired.
    • Prior professional billing experience recommended.
    • Past knowledge of Epic PB Resolute system and/or Athena Health EMR highly desired.
    • Technical/system skills/knowledge: PC and Windows literacy required; prefer knowledge of, or experience with, practice EHR systems, Medicare, Medicaid, and other payer web portals, Encoder Pro, Microsoft Office applications, and Experian claim source clearinghouse portal.
    • Extensive knowledge of insurance/managed care, to include: Medicare; Medicaid (Georgia and Florida); Peach State; Wellcare; CareSource, Amerigroup; Tricare (Standard, Extra and Prime); VA; Disability Adjudication Services; Vocational Rehabilitation; Children’s Medical Services; Cancer State Aid; Crime Victim’s Compensation Program; Knight’s Templar Eye Foundation; Managed Care (HMO, PPO, POS, Medicare HMO, ACA); COBRA; Worker’s Compensation; Blue Cross (Georgia, Florida, out-of-state and FEP); and Institutional Billing.
    • Knowledgeable of insurance and reimbursement process.
    • Must have a thorough understanding and knowledge of: patient type; financial class; insurance master; place of service codes; physician coding; relationship codes; accommodation, occurrence, value and condition codes.
    • Related regulatory and legal requirements: Medicare Secondary Payer Questions; medical necessity; Medical Reviews and Appeals.
    • Interacts with: patients; other departments; physician offices; acute medical care providers; insurance companies; employers; intermediaries; utilization review companies; state regulatory agencies (Medicaid); and attorneys.
    • Knowledge of medical terminology. Strong verbal/written communication skills, highly organized with the ability to prioritize work.
    • Able to communicate effectively with a wide range of individuals. Substantive communication required with physicians, insurance companies, customers and staff. Must be highly organized and self-motivated, requiring little or no supervision to carry out duties. Ability to prioritize and execute multiple tasks to accomplish timely and effective resolution of patient accounts.
    • Working knowledge of medical terminology, revenue, CPT and ICD-10 codes, and 1500 forms.
    • Ability to review and completely understand an EOB, recognize problems, and communicate payer denial trends to supervisor, which prohibit payment from insurance carriers.
    • Ability to maintain acceptable levels of productivity with minimal errors. Requirement is 60 accounts minimum per day once training is completed.
    • Strong analytical, interpersonal and communication skills required.
    • Excellent PC and data entry skills essential.
    • Familiarity with HIPAA privacy requirements for patient information.
    • Excellent customer service skills.
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Job Summary

JOB TYPE

Full Time

INDUSTRY

Hospital

SALARY

$58k-79k (estimate)

POST DATE

04/22/2023

EXPIRATION DATE

05/12/2024

WEBSITE

sgmc.org

HEADQUARTERS

VALDOSTA, GA

SIZE

1,000 - 3,000

FOUNDED

1955

TYPE

NGO/NPO/NFP/Organization/Association

CEO

RONALD E DEAN

REVENUE

$200M - $500M

INDUSTRY

Hospital

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About SGMC

SGMC is a non-profit medical center that provides treatments for cancer, diabetes and orthopedics.

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