Position Summary
The Accounts Receivable Team Lead performs resolution oriented activities with a focus on comprehensive medical billing and collection activity. As the team leader, the Accounts Receivable Team Lead assures the team works collaboratively to support field sales and operational departments. Working with the Revenue Cycle Manager the Accounts Receivable Team Lead is responsible for staff development, supervision and evaluation of their team to ensure service excellence within the organization.
Essential Duties and Responsibilities
The essential functions include, but are not limited to the following:Supports and/or performs daily duties within all areas of the departmentPayment Posting: EFT, credit card, ACH, live check and insurance paymentsResearches and evaluates insurance payments and correspondence for accuracyProcessing and posting of insurance and patient paymentsMatches EOB and payment records with paymentsProcessing write offs according to company policyBatching and scanning of payments to ensure records are on fileAdministrative duties fundamental to successful posting or project operationsBilling: Accurate and timely submission of all claims for all payersDaily claim/invoice submission for primary, secondary, and tertiary payers and/or patient statementsReview rejected claims, perform correction activities and ensure resubmission as appropriateProcess the billing and payment for all Veterans Affairs purchase orders and provide required documentation to the purchasing agent within the contracted timeframeEnsure all Contract Billing Partner billing is submitted to appropriate outsourced partnerCollections: Timely and accurate follow up on unpaid claims or patient accountsWork assigned lists of outstanding claim balances and/or patient accounts with multifaceted issues across different payers and patientsIdentify trends, conduct follow up and perform root cause analysis on unpaid and underpaid insurance claims across different payersAnalyze and resolve billing discrepancies on patient accounts. Ability to explain findings to patientUse persuasive written and oral communication skills to draft appeals and effectively overturn denied or underpaid claimsPerform actions towards remediation of outstanding balances according to policy and procedure; including but not limited to, in depth research appeals, rebilling, calling the payer or clinic, and utilizing payer portalsReview and communicate key statistics and trends to the Revenue Cycle Manager to ensure consistent and efficient department processAssist the Revenue Cycle Manager with routine auditing of billing processes and denial practices and reasonsResearches and monitors trends that impact the department (billing, denials, collections, payments). Recommends revisions to Revenue Cycle Manager.Work collaboratively within the team and other departmentsResponsible for training staff respective to their individual assigned dutiesBe a positive role model willing to share knowledge, skills and expertise with other members of the teamProvide report details to the Revenue Cycle Manager as requiredInterview candidates for the team. Approve PTO, perform 30 day, 90 day, and annual reviews; all other supervisory duties for team membersAttend and participate in status meetings, as well as lead weekly team meetingsEnsure adherence with federal regulatory timeframes for handling cases including acknowledging cases, resolving cases, monitoring effectuation of resolution, completing resolution letters and communicating with members and providers within required time framesWilling to support all members of the teamComply with all HIPAA and privacy regulationsAdhere to laws and best practices in regards to dealing with patients and patient dataPerform other job-related duties as assigned
Minimum Qualifications (Knowledge, Skills, and Abilities)High School Diploma or GED required, college degree preferredExperience with claim submission, payment posting, appeal and denial processes; minimum 2 years requiredExperience in medical device billing and/or general healthcare reimbursement, minimum 2 years requiredUnderstanding of Medicare and commercial insurance carriers plan configurations in respect to calculations of coinsurance, deductibles and percentages, minimum 2 years requiredPrior management experience, minimum 2 years (other relevant experience considered) Understanding of healthcare methodologies (coding, coverage, criteria, payments)Able to work collaboratively and cross-functionally with other departments to facilitate appropriate resolutionsExcellent problem solving and analytical skills, requiredAbility to think and work effectively under pressure and accurately prioritizeDetail-oriented with the ability to conduct research and identify steps required to resolve issues and follow through to effectuationAbility to prioritize work and analyze workflow deficiencies to improve processesAbility to consistently meet appeals accuracy and timeline requirements by achieving regulatory standardsMust have good computer skills, experience with Microsoft Office, requiredExperience with 10-key calculatorAble to communicate clearly, both orally and in writingAble to work effectively with a wide range of peopleTime management skillsExcellent organizational skills and attention to detail
Physical Demands and Work Environment
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.Must be able to work onsite at our corporate headquarters in Maryland Heights, MOMust be able to work in an office setting, use a computer, keyboard and mouse for the majority of the shift and be able to communicate on the telephoneMust be able to work the scheduled 8 hour shift Monday-Friday
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