GBS Convergent Solutions
  • Fairlawn, OH, USA
  • Full Time

 

POSITION SUMMARY:

Are you looking for a dynamic, fast paced and continuously growing medical billing career? Due to revenue cycle platform growth, GBS Convergent Solutions  in partnership with GBS Corp, is looking for ambitious, motivated individuals to join our team!

The Team Lead (TL) Accounts Receivable is responsible to lead the group of AR Representatives. This is a leadership position to guide, direct work load as well as answer questions and assist with any training needs. This position is also responsible to the regular duties of an AR Representative which include following up on claims that have not been adjudicated after 45 days. This person should be able to navigate payer and clearinghouse websites and utilize excellent phone skills when obtaining claim status. The goal is to perform one touch resolution by obtaining all appropriate information, commenting thoroughly and taking appropriate action for adjudication. It is imperative for this position to understand the unique requirements of each individual payer as well as the time limits surrounding claim and appeal submission. It is essential that the AR Representative fully comprehends explanation of benefits from each carrier from several different states as well as being able to identify trends and escalating in a timely manner in order to be managed efficiently.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Department

  • Effectively work from daily AR report
  • Manage production standard designated by Operations Manager
  • Perform daily/weekly QC audits on AR staff
  • Manage AR cycle worked by AR team
  • Awareness of claim submission/appeal deadlines and escalate appropriately
  • Document, escalate and find a solution for trends that might be hindering payment/adjudication
  • Create and contribute to special projects, as assigned by the Manager
  • Follow HIPAA guidelines in handling patient information
  • Understand managed care authorizations and limits to coverage such as the number of visit
  • This is encountered often when billing for specialties; know where to find such authorizations and have claim reprocessed
  • Verify patient benefits eligibility and coverage
  • Performs other duties as assigned and/or assume additional responsibilities as required

Leadership

  • Interview candidates for open positions
  • Provide and direct training for new hires and existing staff
  • Perform employee performance evaluations; perform employee coaching, counseling and distribute corrective actions with HR guidance
  • Address performance opportunities of direct reports firmly and in a timely manner; uses good judgment when difficult decisions are necessary
  • Monitor and approve the team's attendance and time off requests
  • Review and approve overtime requests from the department staff, when applicable
  • Set and be an example of leadership among peers
  • Ensure smooth operations between the team and other departments
  • Provide recommendations, and suggestions for best practice or process improvement within the department
  • Work independently and with the team to meet and exceed overall operational objectives through a comprehensive and well documented process
  • Demonstrate awareness and compliance with GBS-CSI Policies and Procedures

QUALIFICATIONS (Knowledge, Skills, and Ability Requirements)

  • High School Graduate or equivalent
  • Minimum 1 year in a leadership role or proven leadership skills
  • Minimum 5 years of professional/medical billing experience
  • Knowledgeable on insurance and reimbursement process
  • Knowledge of medical terminology
  • Must be able to effectively communicate with physicians, clients and staff employees
  • Must be computer literate and have basic word processing, excel, and calculator skills; computation, typing and filing
  • Effectively cope with change
  • Orchestrate multiple activities at once to accomplish a goal; uses resources effectively and efficiently; detail oriented
  • Widely trusted; keeps information confidential; maintain confidentiality within a HIPAA secure environment

ENVIRONMENTAL/WORKING CONDITIONS

  • Normal office environment
  • Sit for long periods of time; manual dexterity, use a calculator and to operate a computer keyboard; frequent mobility required to access files; bending, stooping, walking and lifting required
  • Must be able to work flexible hours when necessary with occasional extended hours when necessary
  • Mandatory overtime at month-end

 

GBS Convergent Solutions. is an equal opportunity and affirmative action employer. We consider all qualified applicants for employment without regard to race, color, religion, creed, national origin, sex, pregnancy, age, sexual orientation, transgender status, gender identity, disability, alienage or citizenship status, marital status or partnership status, genetic information, veteran status or any other characteristic protected under applicable law.

GBS Convergent Solutions
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