US Eye Financial Counseling Team Lead

JOB SUMMARY:

The Team Lead of Financial Counseling is responsible for the oversight of the financial counseling process to include patient estimation and pre-service collections. The scope of duties is to support all US Eye practices and facilities and to work to standardize financial clearance functions.

ESSENTIAL JOB FUNCTIONS (other duties as required):

• Acts as the first line for day-to-day questions, guidance, and training regarding the financial counseling process, to include insurance verification for benefit determination and accumulations in Phreesia, estimate preparation, and pre-service collections.
• Oversees the team that performs financial counseling and ensuring that functions are performed timely and accurately.
• Assists Senior Manager of Financial Clearance in developing, tracking, and monitoring production and quality measurements for financial counseling.
• Develops, tracks, and reports financial counseling KPI’s at least monthly and more frequently as needed.
• Assists Senior Manager of Financial Clearance to insure that KPI’s are communicated routinely to Senior Manager of Financial Clearance as well as to all team members.
• Assesses, pilots, and implements technology to support efficient operation of insurance verification and financial counseling, insuring workflow efficiency.
• Monitors and manages vendor relationship for financial clearance functions.
• Ensures that financial counseling team members follow documentation, notation, and use of tasking requirements appropriately.
• Serves as a subject matter expert regarding the financial counseling process to include preparing estimates, insurance plan participation, insurance plan selection within the billing system, and insurance plan benefits.
• Maintains payer-specific fee schedules, internal protocols, and provides guidance when needed to support all financial clearance functions.
• Makes recommendations for improving workflow, technology or accountability or communication standards and protocols to avoid under or over collections in the future.
• Monitors and reviews patient accounts receivables for balances greater than $250. Assesses team productivity and quality vs. the standards. Alerts Senior Manager of Financial Clearance regarding any backlogs.
• Monitors and reviews daily dashboard for E&B in conjunction with task work lists for financial counseling. Assesses team productivity and quality vs. the standards. Alerts Senior Manager of Financial Clearance regarding any backlogs.
• Ensures that financial counseling team members support the clinical, operational and administrative teams and patients with training, tools and answers to questions in a timely and accurate way.
• Creates training videos and supports training initiatives with all US Eye practices.
• Identifies opportunities for process improvement in financial counseling processes. Makes recommendation regarding most appropriate course of action to execute on process improvement initiatives. Collaborates with other US Eye operational, clinical or support teams to develop action plans for improvement. Tracks and reports the results of process improvement efforts.
• Develops and provides training for financial clearance, clinical, operational, administrative and RCM teams.
• Participates in feedback reviews with back-end RCM team to identify missed collections opportunities, inaccurate estimates, insufficient patient payments due to flaws in the insurance verification, authorization/referral process. Ensures that remediation efforts are effective and timely and monitors issues to ensure ongoing improvement.
• Adherence to applicable laws, regulations, and contractual obligations. Follows the principles of the Compliance Program as well as the Code of Conduct.
  
  
  

Reasonable accommodations may be made to individuals with disabilities to perform the essential functions.

SUPERVISORY RESPONSIBILITIES:

The position has responsibility for oversight and guidance of a team that is geographically diverse.

WORK ENVIRONMENT:

The work characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Fast-paced, deadline oriented, confidential department. The position will be remote based.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Demonstrated ability to do minimal walking, standing, bending, and stooping. While performing the duties of this job, the employee is frequently required to stand, sit, use hands to handle or feel objects, tools or control, reach with hands and arms and talk or hear. The employee is occasionally required to climb or balance, kneel, and crouch.

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

POSITION TYPE AND EXPECTED HOURS OF WORK:

This is a full -time position.

TRAVEL:

Travel may be required.

REQUIRED EDUCATION AND EXPERIENCE: .

• Three years of leadership of financial counseling process, preferably supporting a physician group practice or practices.
• Financial analysis skills using Excel and/or database software to analyze data.
• Project management skills to support technology assessment.
• Excellent presentation skills and the ability to interpret and explain complex concepts to various levels within the organization.
• Customer service and quality oriented.
• Ability to support team members working in a remote and/or hybrid environment.
• Ability to multi-task and work on multiple assignments simultaneously.
• Ability to work in a fast-paced environment and manage time accordingly in order to meet deadlines and requirements of the organization.
  
  
  

PREFERRED EDUCATION AND EXPERIENCE:

Degree in computer information technology, business administration or a related field preferred.

OTHER DUTIES:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

SIGNATURES:

This job description has been approved by all levels of management.

MANAGER:

DATE:

HR:

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Employee signature below constitutes employee’s understanding of the requirements, essential functions and duties of the position.

EMPLOYEE NAME:

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EMPLOYEE SIGNATURE :

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