TEAM LEAD EOB & ERA PROCESS AUTOMATION

Date: Jul 9, 2024

Location: IN, US

Organization: HHC

Division:Eskenazi Health  

Sub-Division: Hospital  

Req ID:  21146 

 

Schedule: Full Time 

Shift: Days 

 

Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus including at a network of Eskenazi Health Center sites located throughout Indianapolis.

 

 

 

FLSA Status

Non-Exempt

Job Role Summary

The Team Lead/EOB and ERA Process Automation utilizes software to streamline and improve timeliness of 835 file postings and exceptions within the Revenue Cycle related to Professional Billing. This position works closely with appropriate department leadership to discuss problems, needed changes, and to develop procedure flows and specifications prior to implementation of new processes

Essential Functions and Responsibilities

  • Proactively contributes to Eskenazi Health's mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County. Models Eskenazi Health values
  • Utilizes software to streamline and improve timeliness of 835 file postings and exceptions within the Revenue Cycle related to Professional Billing
  • Works closely with appropriate department leadership to discuss problems, needed changes, and to develop procedure flows and specifications prior to implementation of new processes
  • Documents proposed procedures and scripts, tests and debugs all scripts prior to and during user validation
  • Assists with all phases of script implementation and related procedures
  • Monitors all active scripts to ensure continued functionality, works with business owner(s) to make changes as required
  • Manages key scripts as identified by the manager of Cash Management that requires script initiation, results reporting, notification to end users of completion, etc.
  • Maintains master list of all scripts in production that includes key information on the business owner, purpose of script, date implemented, and summary of functionality
  • Works closely with the Director of Professional Billing or their designee from a script development perspective to ensure existing business applications are utilized appropriately to avoid inappropriate data manipulation / corruption, which would negatively impact key stockholders
  • Responsible for the daily operations and technical support of the available computer system(s) and other associated technologies
  • Communicates routinely with internal resources and external vendors who support the system to clarify application development issues and to resolve immediate problems
  • Performs other related duties incidental to the work described above
  • Provides training to new system users and continuing education on specialized system processes
  • Develops and updates user documentation relating to the most effective and productive use of the system.
  • Communicates system issues, payor trends, and contract non-adherence to the appropriate management position
  • Provides technical documentation and updates associates with operational needs and audit requirements
  • Ensures accurate and timely posting of all EOB and ERA payments, discounts, and denials for patient accounts within 24 business hours of deposit
  • Supports associates and assists with the research and resolution of problem postings
  • Balances of all payment and discount postings.
  • Trains associates in appropriate account selection by date of service and / or total charges to ensure proper payment / discount application ensures correct usage of batch numbers and deposit dates to facilitate research capabilities.
  • Possesses extensive knowledge of managed care contracts in order to verify EOB / ERA reimbursements methodologies.
  • Demonstrates advanced knowledge of EOB / ERA formats and payor reason codes to effectively document the patient account.
  • Ensures thorough documentation of EOB / ERA reimbursement explanation in multiple patient accounting systems, according to departmental protocol.
  • Files batch information including checks and EOB's in an organized manner.
  • Responsible for training new hires in the area of cash posting.
  • Responsible for updating the Cash Posting staff in day to day operations
  • Responsible for performing monthly quality performance for the Cash Posting staff.
  • Identifies manual posting errors and provides corrective action in the way of communicating with the cash posting team on areas of needed improvement
  • Provides timely reporting to management of quality reviews performed on the Cash Posting staff.

Job Requirements

  • Associate's degree or equivalent experience required, preferably in business, health or public administration, management, or a related field
  • Minimum of five years of related experience in a hospital/medical environment may be accepted in lieu of educational requirements
  • Must be capable of typing a minimum of 40 wpm

Knowledge, Skills & Abilities

  • Advanced analytical skills with a strong aptitude for logical data flow
  • Clear effective verbal and written communication skills sharing with end users and document accounts.
  • Knowledge of various patient accounting systems
  • Ability to multi-task
  • Skills in multi-tasking between multiple systems, including strong analytical, data management and MS-Excel skills
  • Professional, team-oriented, solution-driven approach to problem solving for all types of issues
  • Detail oriented and possesses effective project management skills
  • MS-Excel and other business office software/tools

 

 

 

Accredited by The Joint Commission and named as one of Indiana’s best employers by Forbes magazine for two consecutive years and the top hospital in the state for community benefit by the Lown Institute, Eskenazi Health’s programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city’s primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana and Sandra Eskenazi Mental Health Center, the first community mental health center in Indiana, just to name a few.