Lead Patient Account Specialist

JOB SUMMARY
The Lead Patient Account Specialist (PAS) is responsible for leading the patient account follow-up and billing management. This role coordinates activities, schedules work assignments and ensures work queues are managed and maintained for the Patient Account team.

JOB REQUIREMENTS

Education

•  High School Diploma or GED

Work Experience

• 2 years of medical billing-related experience required
• Two years of billing call center experience required
• Proficient in the English language. Bilingual (Spanish) is a plus.
• High school diploma or equivalent required

Required Licenses/Certifications

•  None

Additional Knowledge, Skills, and Abilities Required

• Strong knowledge of medical billing processes, insurance carrier payment policies, and practices
• Knowledge of CPT, ICD-9, or medical terminology required
• Strong organizational skills
• Attention to detail, ability to maintain speed while holding up accuracy
• Highly self-motivated and directed in the execution of daily responsibilities and identification or resolution of issues within the span of authority
• Clear, concise, and professional verbal and written communication skills, proficient in English
• Strong listening and interpersonal skills
• Ability to identify, research, and resolve issues
• Computer and MS Office skills required
• Superior customer service skills
• Proactive decision-making skills
• Ability to prioritize multiple tasks

Core Competencies:

• Collaboration: Takes ownership for collectively establishing productive partnerships and relationships and seeks to gain a joint understanding of priorities and objectives so that the greater good of the organization and those we serve is always at the forefront.
• Innovation: Consistently uses good judgment, applying creativity to overcome obstacles and increasing effectiveness and efficiency through process and other forms of innovation.
• Diversity and Inclusion: Fosters diversity and inclusion, to be able to better understand team members, our customers, and partners. Engages the strengths and talents of each GoHealth team member, creating an environment of involvement, respect, and connection where the richness of ideas, backgrounds, and perspectives are harnessed.
• Integrity: Models and practices the highest ethical and professional standards; demonstrates pride and personal interest in our patients, partners, and fellow team members, deeply engaging in the business. Makes decisions, with a focus on doing the right thing; treats team members, our customers, partners, and vendors with dignity, consideration, open-mindedness, and respect.
• Accountability: Always shows initiative, demonstrates a bias to action, and gets things done. Actively accepts responsibility for diverse roles, obligations, and actions that positively influence patient and customer outcomes, our partnerships, and the healthcare needs of our communities.
• (Prioritized) Functional Competencies: to be selected and prioritized by the hiring manager for each position

Additional Knowledge, Skills, and Abilities Preferred

• EPIC and E-Clinical Works systems experience preferred 

ESSENTIAL FUNCTIONS

Essential functions are those tasks, duties, and responsibilities that comprise the means of accomplishing the job’s purpose and objectives. Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable. Following are the essential functions of the job.

• Evaluate and monitor PAS workflow and make adjustments to schedules and assignments as needed to achieve operational goals.
• Directs the Patient Account Services department workload of representatives including auditing work for accuracy and completeness, re-assigning work, and establishing priorities.
• Provides procedure guidance and direction to representatives
• May research, resolve or provide direction on representative's escalated issues.
• Trains representatives on policies and procedures.
• Delegates work with representatives, as needed.
• Monitors representatives for quality and training purposes during down times.
• Identify staff training needs and assist with the delivery of various training programs.
• Identify and research account issues or questions and follow through to resolution
• Assist team members in resolving complex or escalated issues
• Assist PAS Manager in evaluating and developing team members to their fullest potential
• Assist specialists in procuring the information they require to succeed at their job duties
• Communicate regularly with the Manager in regard to the status of assigned accounts and employee performance.
• Maintain appropriate files and records per policy and department guidelines
• Maintain compliance with Company policies and procedures
• Assist manager with interviewing and evaluating potential new employees
• Motivate team members
• Trains representatives on revenue cycle policies and procedures.
• May develop training materials and tools
• Performs other related duties and special projects, as requested.

All other duties as assigned.

Note: This job description is not inclusive of all the duties of the position. You may be asked by leaders to perform other duties. Management reserves the right to revise this position description at any time.