Revenue Cycle Lead - PBS

Position Summary

The Revenue Cycle Team Lead is responsible for serving as a subject matter expert in assisting both internal and external customers with account and payer specific related items.  This position entails being analytical and having the ability to strategically recommend resolutions to trending issues. The Revenue Cycle Team Lead must possess the mindset to independently solve problems and lead the team.

Primary Accountabilities 

1. Extensive knowledge of payer contract regulations and payment policies to ensure proper reimbursement and for compliance purposes
2. Demonstrates Lean concepts in daily activities and is fully committed to the overall success of the organization
3. Actively involved in conference calls/meetings and proactively follows up timely with payer provider reps and necessary parties to assist with the resolution of outstanding accounts/items and trending account issues
4. Responsible for education and training of new hires/transfers and assists with continued training for existing team members; responsible for creating and updating documentation of processes, procedures, and workflows
5. Responsible for providing timely and pertinent feedback to necessary parties, when applicable
6. Proactively participates in activities that improve department operations and/or support to the department for quality improvements
7. Identify system contractual issues and work with Patient Accounts Analysts/applicable parties to implement appropriate tasks to bring AR closer to true expected reimbursement 
8. Actively participates in team meetings/discussions pertaining to follow-up processes, communicating, and presenting in a professional manner
9. Proactively and Independently monitors and analyzes payer trends and reports this information to upper management along with suggesting possible resolutions 
10. Works independently with other Revenue Cycle Specialist team members on various projects to meet organizational and departmental goals
11. Effectively and positively handles internal and external communication including face-to-face interactions, telephone calls, and e-mails
12. Consistently utilizes the Health First Connections model and serves as a positive mentor to other associates
13. Effectively perform the daily job duties of subordinate positions when needed

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities.

MINIMUM QUALIFICATIONS

• Education: High School Diploma or GED
• Licensure: None Required
• Certification: None Required
• Work Experience in Related Field: One (1) year experience in hospital business office environment or healthcare professional business office environment.
• Work Experience in Lieu of Degree: NA
• Knowledge/Skills/Abilities: 

1. Microsoft Office – Outlook, Word, Excel, PowerPoint
2. Demonstrated operational leadership skills. 
3. Excellent verbal, interpersonal and written communication skills
4. Ability to actively guide team members to achieve outcomes with minimal supervision
5. Must consistently handle multiple tasks, often within limited time frames, including assisting with outbound calls, emails, and account resolution as well as inquiry research as business needs require.
6. Strong analytical and critical thinking skills.

PREFERRED QUALIFICATIONS

• Education: Bachelor’s degree
• Licensure: NA
• Certification: NA
• Work Experience in Related Field: 

1. One (1) year experience in hospital business office environment or healthcare professional business office environment.
2. One (1) year experience in working in Health First Patient Accounting systems or applicable practice management systems.
3. One (1) year experience working in Health First PBS departments

• Work Experience in Lieu of Degree: NA
• Knowledge/Skills/Abilities: 

1. Microsoft Office – Outlook, Word, Excel, PowerPoint
2. Demonstrated operational leadership skills. 
3. Excellent verbal, interpersonal and written communication skills
4. Ability to actively guide team members to achieve outcomes with minimal supervision
5. Must consistently handle multiple tasks, often within limited time frames, including assisting with outbound calls, emails, and account resolution as well as inquiry research as business needs require.
6. Strong analytical and critical thinking skills.
7. Working knowledge of medical insurance to include Managed Care payers, Medicare and Medicaid regulations

PHYSICAL REQUIREMENTS

Sedentary – Office Workers

• Sedentary work involves sitting most of the time 
• Walking and standing or lifting more than 10 pounds are required only occasionally
• Must be able to tolerate long periods of computer time a day
• Ability to enter information using hand/wrist dexterity
• Visual acuity and hand-eye coordination to preform various tasks
• Work effectively in a fast-paced and often stressful environment

ABOUT HEALTH FIRST

At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, 

we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our 

associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.