Lahey Health Shared Services is part of a vibrant and growing health care system, recognized as a trailblazer in medicine and a standard bearer in patient experience. It includes an award-winning academic medical center, a superb constellation of community hospitals, home care services, rehabilitation facilities and more.
We are committed to attracting, developing and retaining top talent in a market long recognized and revered as a global leader in health. With a team approach to care, we encourage learning and growth at all levels, and we offer competitive salaries and benefits. We adhere to the principles of a just and fair work environment for all colleagues, where respect is foundational and performance is rewarded.
About the Job
Provides primary support to the Patient Services Supervisor. Researches and resolves the most complicated and oldest patient receivables, patient correspondence and complaints. Implements procedure changes and trains/orients staff.
Essential Duties & Responsibilities including but not limited to:
- Assist Supervisor in organization and operation of the department, acting as leader of staff during supervisor's absence.
- Coordinate all financial matters associated with the patient's visits. Works closely with representatives of Managed Care, Quality Resources, Admissions and other departments as needed.
- Develops, implements, and ensures compliance with departmental policies and procedures.
- Supervises daily work activities of unit employees.
- Gathers, reviews and maintains patient demographic and financial information in the hospital mainframe database.
- Research and resolve patient correspondence and complaints received directly or from Professional Affairs.
- Oversee electronic billing through terminal and PCs located in the department, including billing to Medicare, Blue Cross, NEIC and others.
- Updates and maintains the demographic and financial information in the departmental database. Keeps synchronized with the hospital database.
- Regularly review UB92 requirements to ensure compliance.
- Responsible for training of new employees and ongoing development and training of the staff.
- Responsible for making recommendations regarding hiring, counseling and disciplining employees as deemed necessary.
- Confirms insurance eligibility. Reviews and updates as needed every three months
- Organize and maintain reference materials for staff access.
- Compile and analyze patient call statistics by utilizing telephone system terminal; prepares monthly comparative reports.
- Develops and implements appropriate controls to ensure timely and accurate receipt and processing of charge data for ultimate submission of claims to third party payers.
- Verifies coverage for liver transplant and other related services
- Work with collection agencies to provide needed documentation and resolve open bad debt accounts.
- Review and follow-up on most difficult and oldest receivables.
- Review open self-pay credit balance report on a monthly basis and resolve the oldest and largest credit balances.
- Complie statistics on non-covered charges and work with Supervisor and other departments to minimize, recommend system changes and enhancements, as required.
- Assists the Billing Supervisor when necessary, and assumes responsibility as lead person in the Billing Unit in the absence of the supervisor.
- Meets with patients regularly to communicate information and resolve their concerns and questions
- Participates in regular evaluation process. Interviews patients and identifies potential problems/issues.
- Answer incoming patient telephone calls and respond to inquiries in a timely and thorough manner.
- Conducts regular staff meetings to educate staff, exchange ideas and strategic information.
- Assist Supervisor and Administrative Director with the analyzing of receivable status and developing collection stategy.
- Request trial balance reports and assist in delegation of assignments.
- Maintains an open dialogue with physicians and/or other clinical staff to provide feedback on proper billing codes or requested billing related information.
- Verifies coverage and billing requirements for live donors
- Work on collection lists, when needed, to cover for staff vacancies.
- Monitor cash receipts and receivables to evaluate performance.
- Prioritizes daily work schedules for unit staff and assesses backlog situations, making adjustments where needed.
- Develop and update monthly statistical reports.
- Informs patients of free care program. Assists patient in completing application. Ensures timely response on eligibility or denial.
- Provide regular customer service training to all staff to ensure patients are treated properly.
- Assist in the preparation and operation of regular staff meeting to educate staff, exchange ideas and information.
- Review financial reimbursement. Identify problems and recommend changes to expedite or increase reimbursement.
- Train and orient new employees.
- Communicates and works with other financial supervisors, section leaders and other members of the Patient Accounts management team to increase effectiveness and efficiency of the overall office function and performance, i.e. coding, registration, reimbursement and customer service related issues.
- Identify repeated patient problems or issues and bring to supervisors attention
- Work closely with supervisors and staff in Patient Accounting to coordinate policies.
- Attends and participates in inter/intra-department meetings as required.
- Assist in preparation and operation of regular staff meetings to educate staff and exchange ideas and information.
- Actively participate and contribute to weekly department meetings.
- Performs annual employee performance appraisals for assigned staff.
- Work within the established departmental policies and procedures and adhere to all regulations and standards.
- Inform Supervisor and Administrative Director of regular progress, significant problems or procedural changes.
- Work within the established departmental policies and procedures.
- Perform other related duties and projects, as assigned.
- Adhere to all regulations and safety standards.
- Perform related duties and special projects as required or assigned.
- Education: Bachelor's degree or at least two years of college education or equivalent education and experience.
- Licensure, Certification, Registration:
- Skills: Proficiency in use of personal computers, strong organizational skills, prioritizing demands, verbal and written communication.
- Experience: Requires a broad based the thorough knowledge of patient accounting, typically acquired through a minimum of three years experience in healthcare.
The Lahey Model of Care—right care, right time, right place—is exactly what patients, providers and payers need and deserve. Identifying and delivering on this convergence of interests has positioned Lahey Health for further growth. Our model ensures care is highly coordinated and locally delivered, with lower costs and exceptional quality.
Lahey Health is a robust, regional system including a teaching hospital, community hospitals, primary care providers, specialists, behavioral and home health services, skilled nursing and rehabilitation facilities, and senior care resources throughout northeastern Massachusetts and southern New Hampshire. The system has a global presence with programs in Canada, Jordan and Bermuda.
Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.