Home Healthcare Financial Services Lead

General Purpose

The Financial Services Team Lead manages all aspects of the billing functions and is responsible for ensuring the business maximizes its revenue potential. This position will lead and oversee all revenue cycle management functions by providing leadership, organizational and strategic direction to drive efficient, accurate, and compliant revenue cycle billing activities to maximize reimbursement.

• Develop and implement strategies, processes and technology updates to continuously improve and manage the revenue cycle in a fast-paced, high-volume, evolving home healthcare market.
• Consult and work directly with leadership across business units to advise on key processes and resource needs to improve operations, productivity and collection rates.
• Monitor all major internal and external issues impacting billing, ensuring appropriate actions are taken to address identified issues and provide guidance and expertise as necessary for an effective and compliant resolution.
• Oversee the billing team and the preparation of medical bills, calculation of provider charges and verification of patient insurance.
• Maintain all insurance documents and contracts and manage the timely renewal of those contracts.
• Review requests for authorization needed based upon insurance standards while drawing upon experience and general knowledge.
• Review documentation/contact the provider to supplement the order to prove medical necessity.
• Handle calls related to client benefit eligibility verification and authorization requests.
• Maintain up to date information on insurance companies. Document and communicate relevant changes to appropriate staff.
• Ensure applicable documentation is available and complete before submitting the authorization to avoid repetitive submissions and denials.
• Support payroll processing. Match timesheets to verify visits in the system. Note discrepancies and review with Supervisor to ensure accurate payroll administration.
• Provide reports and information to others as needed to support billing and payroll activities.

• Ability to solve problems, prioritize and multi-task in a deadline and process driven environment
• Performs other assignments as requested.

• May have access to personal health information (“PHI”) necessary to fulfill the above duties and responsibilities. Access to use and ability to disclose PHI is further defined by each organization/department.

• Experience in medical insurance billing and collections experience with a thorough understanding of medical billing rules and regulations required.
• Bachelors in Accounting/Finance or related field preferred.
• 3 years of supervisory or management experience, preferred.

• The ideal candidate will be detail oriented, highly organized and thrive in a team environment.
• Familiarity with ICD-10 and HCPCS Coding Systems.
• Microsoft Office experience and Intermediate Excel skills are a plus.
• Strong written and verbal communication skills.
• Familiarity with Google docs and Google apps.
• Understanding of insurance websites and form fields for authorization submission highly preferred.

• Work is normally performed in a typical interior/office work environment.
• Physical activity is sedentary and may require occasional lifting or carrying up to 10 lbs.
• Ability to sit in front of a computer for long periods of time.