Home Care Billing Team Leader

Job Description

About Us

Akron Children’s Hospital is one of the largest independent pediatric hospitals in the U.S., and ranked among the best children’s hospitals by U.S. News and World Report. Our dedicated staff serves nearly 900,000 patient visits per year through our 2 hospital campuses and a large network of locations offering primary and specialty care.

We are leading the way to healthier futures for children and communities through expert medical care, research, and prevention and wellness programs. As a teaching affiliate of Northeast Ohio Medical University and other universities, we train new generations of pediatricians, specialists, nurses and pharmacists every year.

OUR PROMISES

  1. To treat every child as we would our own
  2. To treat others as they would like to be treated
  3. To turn no child away for any reason

We are seeking people who are committed to fostering a diverse environment in which patients, family and staff from a variety of backgrounds, cultures, and personal experiences are welcomed, included and can thrive.


40 hours/week

Monday-Friday

Day Shift


Summary:
The Team Leader Home Care Billing ensures submission of all DME, infusion, private duty, and skilled nursing visits claims to government and commercial carriers within timely filing deadlines.

 

Responsibilities:

1. Ensures submission of all DME, infusion, private duty, and skilled nursing visits claims to government and commercial carriers within timely filing deadlines.

2. Monitors staff via a quality assurance program to ensure accurate application of charge billing and correction procedures, filing of appeals, work production and timeliness of work completed and identifies and resolves denials.

3. Meets with staff to inform of denial trend information, reimbursement problems, underpayments and escalates issues upward as needed.

4. Shares denial trend information with Managed Care to resolve payment issues at the contract level.

5. Works with Managed Care and CHCG to ensure that contract language garners optimum reimbursement.

6. Assists with the preparation and delivery of corrective action.

7. Educates staff regarding appropriate Home Care billing and coding procedures.

8. Provides timely updates regarding changes to home care billing/coding procedures and correct billing procedures.

9. Identifies and tracks necessary documents for billing and resolving unpaid claims.

10. Creates spreadsheets to reflect performance and trend results.

11. Oversees the submission and tracking of appeals to carriers within the home care billing systems.

12. Other duties as required.

 

Other information:
Technical Expertise
1. Experience in DME, infusion, private duty, or skilled nursing billing and collections is required.

2. Experience in appeals process facilitation is required.

3. Experience in managed care reimbursement, benefit plans, and third party payor requirements is required.

4. Experience in coding compliance for various medical billing types is required.

5. Experience in ICD-9/CPT-4 coding is required.

6. Experience in basic medical terminology is required.

7. Experience working with all levels within an organization is required.

8. Experience in healthcare is preferred.

9. Proficiency in MS Office [Outlook, Excel, Word] or similar software is required.


Education and Experience
1. Education: High School Diploma or equivalent is required; Bachelor’s degree is preferred.

2. Years of relevant experience: 3 to 5 years is preferred.

3. Years of experience supervising: None.

 

Full Time

 

FTE: 1.000000


Akron Children's Hospital is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individual with Disabilities.

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