Position Summary:
The HB Billing and Follow-Up – Team Lead is responsible for ensuring the accurate and timely submission of hospital claims to third-party payors. This role oversees correction of claim rejections and denials, facilitates payer communications, and works to resolve payment delays. The Team Lead supports leadership by assigning daily tasks, mentoring Billing and Follow-Up Specialists, and helping to overcome complex billing barriers.
Key Responsibilities:
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Manage and monitor claims submission, rejection correction, and denial resolution using software such as Epic and Quadax.
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Communicate with third-party payors and patients to gather necessary registration, billing, and collection information.
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Respond promptly and professionally to inquiries from insurance companies, agencies, internal departments, and patients.
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Ensure adherence to department billing and follow-up procedures, workflows, and quality assurance standards.
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Prioritize and organize daily workload; assist team members and cover absences as needed.
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Provide training, mentoring, and support to Billing and Follow-Up Specialists I and II.
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Collaborate with leadership and other team leads to address operational improvements and department initiatives.
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Monitor and apply updates from third-party payors regarding billing and reimbursement policies.
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Maintain proficiency with Microsoft Office Suite and complete all required continuing education.
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Collect and report data on key performance indicators (KPIs) and support special projects.
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Serve as a liaison between leadership and staff, communicating essential information effectively.
Qualifications:
Education:
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High School Diploma or equivalent required.
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College degree preferred.
Certification:
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Preferred: Billing and/or coding certificate from an accredited institution.
Experience:
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Minimum 2 years of hospital billing experience within ProMedica or equivalent.
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Demonstrated success in meeting or exceeding KPIs for promotion consideration.
Skills:
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Proven problem-solving ability with a minimum 80% score on a basic skills test.
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Strong communication, organizational, and mentoring skills.
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Proficiency with billing systems and Microsoft Office applications.
Benefits:
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Competitive benefits package effective from day one, including medical, dental, vision, company-paid life insurance, paid time off, 401(k), employee assistance program, and discounts.
About ProMedica:
ProMedica is a mission-driven, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. Our mission is “To improve your health and well-being.” Learn more at www.promedica.org/about-promedica.
Equal Opportunity Employer:
ProMedica values diversity and inclusion and provides equal employment opportunities without regard to legally protected categories. Accommodations available upon request per ADAAA guidelines.