Revenue Cycle Specialist Lead - CPAR Certification Required

Job Category:

Revenue Cycle

Work Shift/Schedule:

8 Hr Morning - Afternoon

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

About the Role:

Job Summary

This position is responsible for assisting the Patient Contact Center Supervisors and Manager in managing the day-to-day operation of the Patient Contact Center. Assists in monitoring call volumes to ensure achievement of service standards, including taking calls during high volume periods. Responsible for specialty accounts to include: high balance accounts, payroll deduction and long-term payment plan processing, deceased and estate accounts, bad address/held statement review, bankruptcy processing, and client (non-patient) billing and collections. Provides staff with support, answering questions and ensuring the team consistently provides accurate information and exceptional customer service. Responds as needed to escalated calls and serves as department liaison for systemwide Patient Complaint Management System. Assists with monitors daily, weekly, monthly Patient Contact Center reports to achieve goals and service standards. Assists with monitoring the team’s customer service skills, working with the Patient Contact Center leadership in identifying areas that require further development/training. 

Minimum Job Qualifications

• Licensure or other certifications: CPAR Certification

• Educational Requirements: High School Diploma

• Minimum Experience: Five (5) years minimum collection, hospital or business office experience

• Other:

Preferred Job Qualifications

• Preferred Licensure or other certifications:

• Preferred Educational Requirements: Two (2) years of college or Business School

• Preferred Experience:

• Other:

Job Specific and Unique Knowledge, Skills and Abilities

• Working knowledge of the Revenue Cycle processes and goals

• Personal computer proficiency to include all Microsoft Office programs and Revenue Cycle systems necessary to perform job duties, including proper documentation

• Excellent problem-solving skills with attention to details

• Excellent customer service skills

• Excellent verbal and written communication skills

• Ability to work independently within guidelines

• Can adapt to change quickly in a fast-paced demanding environment.

• Maintains thorough understanding of the Patient Complaint Management System

• Working knowledge of automated dialer systems

• Ability to prioritize, organize, and coordinate daily workload

• Ability to serve as a resource for all Revenue Cycle personnel from pre-services through collections

Essential Tasks and Responsibilities

• Be in good standing with all Facility policies including those related to attendance, positive attitude and staff development. Follow all department guidelines, policies and procedures.

• Attends all Weekly/Monthly/Quarterly/Annual SPRC and Team Meetings (Unless has an excused absence).

• Be a positive role model to all staff members, physicians, patients and visitors.

• Assist with onboarding, training and support new team members.

• Assist with ensuring Patient Contact Center is compliant with all standards, guidelines and policies.

• Work with PCC Supervisors and Manager to ensure monthly key contact center performance goals for quality, productivity and key performance metrics are met.

• Provide feedback to PCC Supervisors and Manager to assist with monitoring and evaluating staff monthly performance including call monitoring, and attendance and coach staff members to improve performance.

• Report, analyze and resolve system, customer and operational issues that impact service quality.  Strive to provide all customers with outstanding customer experience.

• Collect, analyze and summarize data and track trends from various performance and audit reports.

• Ensure that customers' questions and problems are resolved properly and quickly. Address challenging customers and problems that require escalation to PCC Leadership and to other departments outside SPRC. Review and resolve complaints logged on SPRC complaint tool received by PCC staff and referred to PCC using NGHS complaint tool.

• Review specialty accounts for resolution and trending. High balance accounts from various sources for such actions as third-party rebilling, collection agency referral, or other options to appropriately resolve account balances. Process deceased and bankruptcy accounts according to state and federal guidelines. Review and process bad address and held statement accounts.  Bill and collect client (non-patient) balances. Manage payroll deduction and long-term payment plan processes, including recourse and reconciliation.  Serves as department liaison for systemwide Patient Complaint Management System.

• Build and establish open lines of communication with staff, peers, managers and other areas of NGHS to facilitate problem solving.

• Help identify trends impacting performance and facilitate cross-training between staff.

• Manage call center tools and resources: auto dialer maintenance, campaign review and revisions, collect and tracking call center statistics (accuracy, call wait times, abandonment rate) to ensure top performance.

• Assist with vendor liaison for invoice processing, reconciliation reports, account transfers, system request and facilitate onsite/offsite visits.

• Maintain superior knowledge of patient accounts and department revenue cycle operations.

• Process payroll deduction and long-term payment plan accounts in a timely manner. Assist Vendor with monitoring, reviewing and making recommendation for process and policy improvements.

• Think critically and make reasonable judgments on patient accounts.

• Adapt to frequently changing atmosphere including organizational and technological changes.

• Maintain knowledge and understanding of insurance/patient billing and collections.

• Maintain advanced knowledge of state collection laws and Fair Debt Collection Practices Act.

• In addition to the above tasks and responsibilities, the Patient Contact Center Team Lead will be responsible for and must be proficient in all job duties of a Patient Contact Center Representative. These duties include but are not limited to: Accepts all calls via the ACD (Automated Call delivery) lines in a manner that keeps wait times to a minimum. Performs collection activities on outstanding patient balance, offering payment arrangements per guidelines when patient unable to pay in full. Follows required collection process. Applies resolution to patient calls based on established standards and procedures. Reviews accounts thoroughly, verifying balance to be correct. Performs required action to correct balances found to be in error. Refers errors to other departments for assistance only when appropriate.  Documents and uses appropriate disposition codes in system for every account, including any action taken in order to allow for trending and process improvement. 

Physical Demands

• Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time

• Weight Carried: Up to 20 lbs, Occasionally 0-30% of time

• Vision: Moderate, Constantly 66-100% of time

• Kneeling/Stooping/Bending: Occasionally 0-30%

• Standing/Walking: Occasionally 0-30%

• Pushing/Pulling: Occasionally 0-30%

• Intensity of Work: Frequently 31-65%

• Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding

Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. 

NGHS: Opportunities start here.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.