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Team Lead – Appeals & Revenue Cycle Projects

*ETHOS LABORATORIES* – Newport, KY

LOCATION: This position is located in Newport, KY, two blocks from Newport on the Levee.

HOURS: Monday – Friday, 7:30AM – 3:30PM

POSITION SUMMARY:

The Appeals & Revenue Cycle Projects team lead is responsible for the day to day operations and workflow of the Appeals team as well as managing revenue cycle projects assigned within the Billing Department. Responsible for building and maintaining collaborative and productive relationships within the department and organization, helping drive performance, troubleshooting and providing direction on workflow. Audits and ensures productivity standards are met within Appeals team. Actively communicates with Billing Manager. This position requires attention to detail, exceptional interpersonal skills, developed technical skills and strong leadership abilities.

EDUCATION AND EXPERIENCE REQUIREMENTS:

  • High School Diploma or GED
  • 3 years of Appeals experience
  • 2-4 years of experience associated with progressive responsibility, overseeing people and processes

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

  • Identifies complex billing and reimbursement issues and reviews related information to develop and evaluate workflow and implement solutions
  • Prepares supporting documentation that illustrates the impact on the revenue cycle or improvement to existing processes
  • Monitors and communicates positive and negative trends and issues that may affect lab billing and reimbursement
  • Analyzes large sets of data to uncover key insights in regards to increasing and/or decreased reimbursements
  • Encourages positive communication and interactions within the department and interdepartmentally to increase collaboration and teamwork
  • Performs the duties of Appeals Specialist as needed
  • Responsible for documenting and performing Appeals Specialist monthly audits
  • Tracks and maintains data and performance indicators on a daily, weekly, monthly, quarterly and annual basis
  • Reviews and processes requests for refunds
  • Effectively delegates tasks to maximize strength of employees
  • Communicates any changes or adjustments to workflow
  • Assists in reviewing and creating SOPs and forms when needed for Appeals and Billing Department
  • Assists in effectively troubleshooting issues as they arise in regards to billing and reimbursement
  • Ensure completion of tasks and delegate additional tasks essential to the Appeals process
  • Participates in meetings and special projects
  • Identifies possible training deficiencies
  • Performs on-boarding and orientation activities with new employees
  • Trains new and existing employees on Billing Department processes
  • Ensures completion of training checklists for Appeals
  • Performs competency assessments for Appeals Specialists, twice within first year, and then annually thereafter
  • Documents incidents and accidents on the appropriate forms and ensures Billing Manager is aware of these in a timely manner, depending on the seriousness of issue
  • Assists in ensuring adherence to company policies, including attendance, dress code, lab safety and punctuality
  • Ensures adherence to all regulatory requirements
  • Communicates issues, as needed, to Billing Manager, in a timely manner, and provides verbal summary of payment posting activities, issues, resolutions, etc. at production meetings

CORE COMPETENCIES AND QUALIFICATIONS:

  • Must be able to motivate, coach and mentor employees for the highest level of performance
  • Must be able to prioritize and perform multiple tasks in a dynamic environment
  • Ability to model time management, conscientiousness, dedication, self-discipline, accountability, and responsibility
  • Ability to work independently and cohesively as part of a team
  • Ability to foster an environment of employee development and collaboration within and amongst departments
  • Must be able to delegate and accomplish goals through others
  • Requires a high level of attention to detail, critical thinking and problem solving
  • Ability to exercise independent judgment
  • Utilizes leadership principles to anticipate and influence change
  • Prompt and regular attendance
  • Effective verbal and written communication
  • Excellent phone etiquette
  • Knowledge of all aspects of the Revenue Cycle
  • Ability and experience with Microsoft Outlook, Word, and Excel
  • Follows all department and company policies and procedures