Lead, Upfront Review

This employee monitors quantity and quality of documentation entry within a specific timetable.

Job Responsibilities:

• Assign duties and examine work of subordinates for exactness, neatness, and conformance to policies and procedures
• Maintains harmony among workers and helps to resolve grievances
• Obtain payer requirements for documentation to release from held sales
• Coordinates with AR teams on payer denials or partial payments
• Document all activity in customer's computer account
• Answer center inquiries on customers in a held status
• Work held sales reports to target payers or specific equipment that is resulting in excessive held sales
• Identify and resolve complex issues
• Assist management in training and coaching other team members
• Complete random review of documentation used by team members as billable documents

• Extensive knowledge of Medicare, Medicaid, and other government or private payer reimbursement rules
• Computer literacy, minimum key boarding skills, and proficiency in the use of office equipment required for performance of assigned duties
• Knowledge of telephone etiquette with adequate oral and written communication skills

Education and Experience:

• High School Diploma or equivalent required
• Has at least 3 yrs and/or knowledge equivalent experience
• Past performance shows solid evidence of payer qualifications and guidelines

Physical Demands:

The employee must occasionally lift and/or move up to 25 pounds.