CBO Patient Financial Services Lead

Position Summary / Scope of Responsibility

MedVanta is the nation's largest physician-owned and operated next generation management services organization (MSO). Our services are specifically designed for musculoskeletal (MSK) providers and go beyond that of a traditional MSO, empowering our clients with the precise infrastructure, data, technology, and administrative processes needed to thrive both today and tomorrow.

MedVanta has an employee centered culture that supports and promotes diversity and inclusion. Our encouraging and empowering management style makes MedVanta a great place to further grow your knowledge while building a team driven path to success.

The PFS Team Lead plays a pivotal role in supporting the Central Billing Office (CBO) by overseeing the daily operations of the Patient Financial Services team. This position is responsible for guiding team performance, managing escalations, ensuring high-quality patient interactions, and supporting team development. The Team Lead also works closely with internal departments and leadership to ensure timely and accurate service delivery.

Primary Responsibilities

• Serve as the primary point of contact for team assistance and handle Tier 2 escalation calls and complex patient account issues.

• Collaborate with the Tier 1 escalation representative to ensure team coverage and issue resolution.

• Audit team performance and results, adjusting for improvement as indicated.

• Lead team huddles and productivity meetings to reinforce goals, share updates, and ensure team alignment.

• Act as a liaison for interdepartmental communication and collaborate with leadership on escalated matters.

• Lead training and onboarding of new team members, providing continuous support and development.

• Review the call auditors’ spreadsheet regularly to identify areas of improvement; address concerns or trends with individual team members to improve call quality and service.

• Deliver constructive feedback and coaching to enhance team effectiveness and performance.

• Identify inefficiencies and implement strategies to improve workflows and team performance.

• Identify and propose opportunities to maximize Patient A/R revenue.

• Conform with and abide by all regulations, policies, work procedures, and instructions.

• Oversee critical reports such as card-on-file reports, statements on hold, and productivity metrics.

• Prepare and distribute standard reports, including productivity metrics, card-on-file reports, statements on hold, and Patient A/R reports.

• Assist in preparing monthly pre-collection and collection agency files.

• Perform selected medical billing functions when needed, including billing, claims submission, account follow-up, payment posting, and adjustments.

• Review delinquent accounts and call for collection purposes.

• Communicate accurate patient and billing/claims information to insurance carriers.

• Answer incoming patient phone calls and make outbound collection calls on open balances.

• Update patient insurance, confirming eligibility and queue claims for billing.

• Update demographic and guarantor information in the Patient Accounting System.

• Handle patient inquiries to address billing questions via inbound calls and patient correspondence.

• Fulfill patient requests for itemization of charges, adding/verifying/billing insurance, establishing payment plans, processing adjustments, requesting refunds, and explaining policy and guidelines.

• Initiate patient outreach on delinquent payment plans, adding accounts to existing payment plans and high-risk/balance accounts.

• Review, address, and monitor credit balances to ensure compliance with regulatory and contractual obligations.

• Evaluate accounts for bad debt placement and work with the bad debt vendor on patient issues and concerns.

• Receive and process patient credit card payments, and allocate to appropriate visits on the account.

• Post appropriate discounts and adjustments to patient accounts.

• Manage and work queues and worklists in the patient billing system.

• Interact with supporting departments (coding, cash-ops, AR follow-up) to resolve billing and payment issues.

• Work across departments (AR, coding, cash operations) to resolve billing and payment issues effectively.

• While not regularly in the call queue, assist with inbound and outbound calls during periods of critical staffing shortage.

• Monitor patient voicemails and ensure timely responses by assigning or sending out follow-up voicemails to team members to ensure patient inquiries are addressed promptly.

• Clearly and promptly communicate policy or workflow changes to the team.

• Other duties as assigned.

Requirements, Education, and Experience

• High school diploma or equivalent required.
• Minimum 5 years of experience in medical billing or revenue cycle operations; orthopaedic experience preferred.
• Proficiency with Microsoft Office suite of products as well as electronic billing systems
• In-depth knowledge of insurance processes, medical billing practices, and regulatory guidelines.

 Competencies / Required Skills and Abilities 

• Strong Interpersonal Skills - Ability to develop relationships and collaborate and influence in a decentralized organization.

•  Strong leadership, communication, and coaching skills.

•  Ability to multitask in a fast-paced environment while maintaining attention to detail.

•  High level of professionalism and discretion in handling sensitive matters.

•  Proactive problem-solver with a team-first mindset.

• Demonstrated ability to organize, prioritize, and manage multiple tasks in a dynamic environment with a proven track record of results.
• Strong interpersonal, oral, and written communication skills with excellent self-discipline and patience.
• Able to work independently.
• Exudes professionalism in presentation.
• Must be able to read, write, speak, understand and communicate in the English language.

Physical Demands

• Must be able to sit for long periods of time and lift up to 25 pounds. 
• Must be able to use appropriate body mechanics techniques when performing desk duties. 
• Requires frequent bending, reaching, repetitive hand movements, standing, walking, squatting, and sitting.
• Adequate hearing to perform duties in person and over telephone.
• Must be able to communicate clearly to patients in person and over the telephone.
• Visual acuity adequate to perform job duties, including reading materials from printed sources and computer screens.