Patient Financial Services, Team Lead

Patient Financial Services, Team Lead

POSITION SUMMARY:

Under the direction of the Assistant Director and the Assistant VP of Revenue Cycle, the Patient Financial Services (PFS), Team Lead is responsible for managing staff assignments and providing excellent leadership to staff members. The PFS Team Lead will assist with the management of the claim scrubber and electronic billing system to submit and rebill corrected claims as needed. The PFS Team Lead will be responsible for managing the Accounts Receivables as well as understanding managed care contracts and governmental updates. The PFS Team Lead will provide training, support and feedback to staff. Participate in Revenue Cycle Committee meetings, initiatives and projects as directed.

RESPONSIBILITIES:

• Manages Accounts Receivables.
• Sets-up access to systems and payer portals.
• Must be able to interpret third party coverage and contract reimbursement.
• Reviews, documents, and communicates all processes related to insurance and patient billing, follow up, credits denials, and appeals.
• Ensures accounts are billed and followed accurately, timely, and in a compliant manner.
• Processes and works explanation of benefits related to claims adjudication.
• Keeps abreast of all billing and reimbursement regulations and standards to ensure compliance with any published or anticipated changes issued by governmental agencies and/or third-party payers.
• Meets regularly with staff to provide support and feedback.
• Shares knowledge with staff through verbal and prepared written communication.
• Assists with staff training, creating educational content and job aides.
• Demonstrates effective communication and teamwork by fostering a collaborative environment and promoting positive working relationships across the Revenue Cycle team and other departments.
• Assists with payment review and denials management.
• Addresses and/or resolves credit balances.
• Monitors staff work queues and assignments.
• Monitors staff, including performance, schedules and overtime.
• Participates in process improvement initiatives.
• Participates with audits both internal and external.

• Assists with management of vendor/business partners.

REQUIRED EXPERIENCE AND QUALIFICATIONS:

• High School diploma or equivalent required.
• 5 years prior healthcare billing experience and knowledge of CPT, ICD-10, medical terminology required.
• Knowledge of Word and Excel applications.
• Must be able to adapt to system changes, manage heavy call volume, be a self-starter, organized, detail oriented.
• Bilingual speaking is a plus.

PREFERRED EXPERIENCE AND QUALIFICATIONS:

• College degree and or certifications in billing and coding preferred.

PHYSICAL DEMANDS:

• Lift stored document boxes up to 10 lbs.

• Required to sit for long periods of time interspersed with standing, walking and bending.

As part of employment at Southampton Hospital, there may be occasions when travel to other locations is needed to support operational needs.

• Stony Brook Medicine is a smoke free environment. Smoking is strictly prohibited anywhere on campus, including parking lots and outdoor areas on the premises.
• All Hospital positions may be subject to changes in pass days and shifts as necessary.
• This position may require the wearing of respiratory protection, which may prohibit the wearing of facial hair.
• This function/position may be designated as “essential.” This means that when the Hospital is faced with an institutional emergency, employees in such positions may be required to remain at their work location or to report to work to protect, recover, and continue operations at Stony Brook Medicine, Stony Brook University Hospital and related facilities.

Anticipated Pay Range:

The starting salary range (or hiring range) for this position has been established based on relevant experience.

The above salary range (or hiring range) represents SBSH’s good faith and reasonable estimate of the range of possible compensation at the time of posting.

Your total compensation goes beyond the number in your paycheck!

• Complete electronic reference check with a minimum of three (3) professional references.
• Successfully complete a 4 panel drug screen*
• Meet Regulatory Requirements for pre-employment screenings.
• Provide a copy of any required New York State license(s)/certificate(s).

• The hiring department will be responsible for any fee incurred for examination.

Company Overview:

Stony Brook Southampton Hospital as part of Stony Brook Medicine provides direct access to the highest level of academic-based medical care. Located in the heart of the village of Southampton, two hours from New York City, the hospital provides healthcare services to a diverse community of year-round residents, second homeowners and vacationers. The population, about 75,000 in the winter months, increases sharply to more than 300,000 in the summer. Stony Brook Southampton Hospital has been recognized as a Long Island Top Workplace by Newsday among large employers (defined as having 500 employees).

StaffCo is a Professional Employer Organization, commonly referred to as a PEO, duty organized and registered under the New York Professional Employer Organization Law. StaffCo and SUNY have entered into a professional employer agreement under which StaffCo is the employer of Stony Brook Southampton employees and responsible for employment, including, promotions, disciplines, terminations, the day-to-day direction and supervision of work, as well as labor relations and collective bargaining. StaffCo is fully responsible for providing all payroll and human resource services, including the payment of wages, collecting and reporting payroll taxes and maintaining any and all employee benefits. SUNY Stony Brook Hospital is responsible for the operation of the hospital and provision of health care and is the co-employer as is necessary to conduct its responsibilities and for related licensure, regulatory or statutory requirements and obligations.

Given StaffCo’s employment responsibilities, it is deemed the “employer” for employment and labor law purposes. Thus, the employees are private sector employees of StaffCo, not public sector employees of SUNY. The private sector nature of the StaffCo employees has been approved by NYS Civil Service and upheld in a decision by the US National Labor Relations Board.

Stony Brook Medicine is committed to excellence in diversity and the creation of an inclusive learning and working environment. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, familial status, sexual orientation, gender identity or expression, age, disability, genetic information, veteran status and all other protected classes under federal or state laws.

Stony Brook Southampton Hospital, consistent with our shared core values and our intent to achieve excellence, remains dedicated to supporting healthier and more resilient communities, both locally and globally.