Lead Patient Account Specialist
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.
High School Diploma or GED
Work Experience • 2 years of medical billing related experience required
• Two years billing call center experience required
• Proficient in the English language. Bilingual (Spanish) a plus.
• High school diploma or equivalent required
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 execution of daily responsibilities and identification or resolution of issues within 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
• Collaboration: Takes ownership for collectively establishing productive partnerships and relationships and seek to gain 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 though 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 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 work load 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 representatives escalated issues.
• Trains representatives on policies and procedures.
• Delegates work to representatives, as needed.
• Monitors representatives for quality and training purposes during down times.
• Identify staff training needs and assist with 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 regards 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.