TEAM LEAD EOB & ERA PROCESS AUTOMATION

FLSA Status

Job Role Summary

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