Lead Patient Representative

GPH - North Platte NE Hospital Corp DBA Great Plains Health; United States; On-site; USD 55,000 - 75,000; Full time

Job summary

Great Plains Health is seeking a Lead Patient Representative within the Patient Financial Services department. The role supports billing, insurance follow-up, denials management, and cash application while mentoring staff and monitoring production and quality metrics.

The Lead serves as a first escalation point and helps optimize workflows across departments to ensure accurate data and efficient processes. Responsibilities include training new staff, participating in onboarding and evaluations,

Qualifications

• High school diploma or equivalent is required.

Responsibilities

• Perform scheduled audits of billing, collections, denials, credits, cash application and vendor management.
• Participate in daily huddles, one-on-ones, weekly/monthly meetings, onboarding and evaluations.
• Train and orient new employees, develop new workflows and retraining as needed.
• Assist in maintaining and improving Patient Financial Services software systems and tools.
• Meet or exceed key performance indicators such as clean claim rates, DNFB, AR aging, and denials reductions.

Education

High school diploma or equivalent

Job description

Job Title: Lead Patient Representative Cost Center: Patient Financial Services

Job Description: The Patient Financial Services Lead is responsible for the support of the team functions necessary to accomplishing the objective of the department. These include, but are not limited to functions under the categories of billing, insurance follow up, denials management, cash application, credit management, support services and vendor management. The Lead is responsible for training and education of new and current team members and assists the manager in monitoring production and quality statistics for staff as well as making recommendations for improving productivity/quality. Serves as a resource for team members, answering questions and resolving issues, first level of escalation prior to management intervention.

Minimum Qualifications

• Education
• High school diploma or equivalent required.
• Credentials
• None

Physical Demands

• 1. Stand and/or walk frequently. Sit frequently.
• 2. No lift and/or carry.
• 3. No push and/or pull.
• 4. Visual acuity and manual dexterity within normal limits.
• 5. Bend, stoop, and crouch occasionally
• 6. Reach floor to overhead occasionally.
• 7. Computer use frequently.

Essential Functions

• 1. Perform scheduled audits of billing, collections, denials, credits, cash application and vendor management as generated through HB and PB Resolute applications. Follow up as necessary with staff to ensure accuracy of data and address areas of targeted improvement.
• 2. Actively participates in daily huddles, one-on-ones, weekly/monthly meetings as well staff onboarding and annual evaluations.
• 3. Actively participates in training and orientation of new employees, development of new workflows and re-education of existing staff as needed.
• 4. Participates in the development, implementation and/or maintenance of all Patient Financial Services related software systems and products, including but not limited to billing clearinghouses, denials software, and payer websites and tools.
• 5. Meets and/or exceeds assigned key performance indicators within Patient Financial Services, including but not limited to clean claim rates, DNFB rates, AR Aging, denials reductions as well as any specified vendor performance and credits reductions.
• 6. Acts as the first point of escalation regarding any concerns or issues before manager intervention and serves as a point of escalation for operational issues for internal and external sites.
• 7. Assist in managing W/Q’s when staff are absent.
• 8. Actively works with NMC on opening tickets and working on enhancements to improve processes within the Patient Financial Services Dept.
• 9. Responsible for working collaboratively with other departments within the hospital to maintain a good relationship between departments.
• 10. Together with other work group leads as well as defined reps (such as vendor management and revenue integrity), works as a team to assist the department in meeting goals.
• 11. Compiles production statistics for daily, weekly, monthly and quarterly reports.
• 12. Additional duties as assigned.

Join us. Join great. Join the dynamic team at Great Plains Health and be a part of something truly exceptional. At Great Plains Health, we embody a culture defined by authenticity, integrity, and a genuine commitment to listening to both our patients and each other. As a member of our team, you'll experience a supportive environment where collaboration is key, and every voice is valued. We work together seamlessly, leveraging our collective strengths to provide the highest quality care to our community. Passion drives us forward, propelling us to constantly strive for excellence in everything we do. If you're seeking a rewarding career in healthcare surrounded by like-minded individuals who share your dedication and enthusiasm, Great Plains Health is the place for you. Come join us and be part of a team that's making a real difference every day. We are rooted in passion. We pursue excellence, innovation and world-class quality every day. Here, you'll find a team that works together in the interest of unmatched patient care. You'll find positive attitudes, advanced technology and a collegial culture. You'll find an appreciation for the healthcare roles and a commitment to professional growth. Here, you’ll find purpose and connection in an independent hospital driven to inspire health and healing by putting our patients first—always.