Lead Medicaid MCD MGN Followup

Education Required: High School diploma or equivalent Experience Required: 1 year business office experience Skills Critical thinking Excellent computer skills and strong aptitude to learn and maximize use of applications Licensure/Certification/Registration N/A Overall Physical Demands Material Handling Occasional Squat Lifting 30 Pounds Bilateral Carry 30 Pounds Unilateral Carry 15 Pounds Pushing 10 Pounds Pulling 10 Pounds Repetitive Functional Activities Never Occasional Frequent Constant Walking X Above Shoulder Reach X Bending X Stairs X Forward Reach X Ladder X Squatting X Fine Motor Coordination X Static Balance X Sustained Squatting X Dynamic Balance X Gross Motor Coordination X Repetitive Kneeling X Sustained Kneeling X Simple Grasp X Crawling X Firm Grasp X Pinching X Sit/Stand Hrs per Day Hrs at One Time Sit 8 hours 2 hours Stand 4 hours 1 hour Sedentary job demands Material Handling Occasional Squat Lifting 30 Pounds Bilateral Carry 30 Pounds Unilateral Carry 15 Pounds Pushing 10 Pounds Pulling 10 Pounds Repetitive Functional Activities Never Occasional Frequent Constant Walking X Above Shoulder Reach X Bending X Stairs X Position Competencies: Competencies are essential skills needed to be successful in a position. These competencies are required to help the department maintain a high level of productivity and success. Each competency will be evaluated by observation. If evaluated by another method i.e. simulation, discussion or post test please note in the comment box below each corresponding competency. Works collaboratively with Patient Access, Central Access, Central Precertification, Audit Compliance and other departments as needed in resolution of denials. Research credit balances using payer and regulatory guidelines to ensure refunds are issued appropriately. Review refunds requested by team and approve/deny as appropriate. Complete special projects as assigned applying specialized job knowledge. These projects may include other system departments and is not limited to Patient Financial services. Assist in leading the team to accomplish all job objectives by utilizing skills to inspire teamwork, quality, accountability and ownership among the team. Promotes continuing education and personal growth among team members through encouragement and seizing "teachable moments" to promote continual learning. Demonstrates pride and ownership in work through appropriate attention to detail, good work quality and the initiative to continuously improve Maintains open communication lines with staff members and other departments. Consistently communicates with all parties in an appropriate, effective and professional manner. Alerts supervisor of pertinent issues or opportunities. Utilizes appropriates lines of communication to promote problem solving and decision making and communicates results, demonstrating tact and good judgment Keeps manager/supervisor advised on status of assigned job tasks and requests assistance with tasks when workload warrants additional resources or overtime Assure established performance metrics are exceeded. Working knowledge of revenue cycle and active advancement of patient accounts to reach hospital cash goal. Work with the Medicaid HMO provider reps to resolve claim issues Assist with reviewing and working with the Out of State Medicaid vendor Maintains comprehensive knowledge of Medicaid and Medicaid Managed care plans.