Medi-Centrix offers a physician-focused approach to revenue cycle management, data extraction, and decision support. We help physicians navigate the healthcare landscape as it evolves and prepare you for participation in value-based care arrangements and bundled payment models. To ensure that our strategy and deliverables continue to address the most pressing needs of today's physician community, we rely on our Physician Advisory Board to provide valuable insights.
The AR Follow Up Team Lead supports management team with the coordination of activities and operations of AR Follow up department.
Assist AR representative team members by answering questions and providing support for their ongoing success
Provide initial training on the client host system
Assist and support AR follow up representatives with research on A/R related projects
Assist in tracking productivity and quality of AR Representatives
Identify areas of opportunity for improvement through one on one evaluation of AR Representative team
Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
Meets and maintains daily productivity/quality standards established in departmental policies and supports training needs identified to ensure teams success in this area
Meets and maintains quality standards established in departmental policies and supports training needs identified to ensure the teams success in this area
Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts
Adheres to the policies and procedures established for the client/team
Knowledge of timely filing deadlines for each designated payer
Initiate appeals when necessary
Ability to identify and correct medical billing errors
Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process
Ability to analyze, identify and resolve issues causing payer payment delays
Ability to analyze, identify and trend claims issues to proactively reduce denials
Understanding of under payments and credit balance process
Perform special projects and other duties as needed. Assists with special projects by utilizing excel spreadsheets, and the ability to communicate results
Act cooperatively and courteously with patients, visitors, co-workers, management and clients
Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
Work independently from assigned work queues
Maintain confidentiality at all times
Maintain a professional attitude
Other duties as assigned by the management team
Qualifications and Skills
Experience in insurance collections, including submitting and following up on claims for a Medical Practice, Medical Facility/Medical Billing Company, Ambulatory Surgical Center, and/or Hospital
Experience with the Client's host system.
Experience with training new users
Physician/Professional Billing:
Knowledge of the denied claims and appeals process
Extensive knowledge of individual payor websites, including Navinet and Novitasphere
Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes
Ability to work well individually and in a team environment
Proficiency with MS Office. Must have basic Excel skillset
Experience with practice management systems. EPIC PB, Allscripts and/or Cerner preferred
Strong communication skills/oral and written
Strong organizational skills
Working Conditions
General Office Environment
While performing the duties of the job, the employee is occasionally required to move around the work area
Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear
The employee must be able to follow directions, get along with others and handle stress
The noise level in the work environment is usually minimal
Medi-Centrix provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Medi-Centrix complies with applicable state and local laws governing nondiscrimination in employment in every location where the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.