Accounts Receivable Team Lead

St Louis, MO
Full Time
Manager/Supervisor
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 department
    • Payment Posting: EFT, credit card, ACH, live check and insurance payments
Researches and evaluates insurance payments and correspondence for accuracy
      • Processing and posting of insurance and patient payments
      • Matches EOB and payment records with payments
      • Processing write offs according to company policy
      • Batching and scanning of payments to ensure records are on file
      • Administrative duties fundamental to successful posting or project operations
    • Billing: Accurate and timely submission of all claims for all payers
      • Daily claim/invoice submission for primary, secondary, and tertiary payers and/or patient statements
      • Review rejected claims, perform correction activities and ensure resubmission as appropriate
      • Process the billing and payment for all Veterans Affairs purchase orders and provide required documentation to the purchasing agent within the contracted timeframe
      • Ensure all Contract Billing Partner billing is submitted to appropriate outsourced partner
    • Collections: Timely and accurate follow up on unpaid claims or patient accounts
      • Work assigned lists of outstanding claim balances and/or patient accounts with multifaceted issues across different payers and patients
      • Identify trends, conduct follow up and perform root cause analysis on unpaid and underpaid insurance claims across different payers
      • Analyze and resolve billing discrepancies on patient accounts. Ability to explain findings to patient
      • Use persuasive written and oral communication skills to draft appeals and effectively overturn denied or underpaid claims
      • Perform 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 portals
  • Review and communicate key statistics and trends to the Revenue Cycle Manager to ensure consistent and efficient department process
  • Assist the Revenue Cycle Manager with routine auditing of billing processes and denial practices and reasons
  • Researches and monitors trends that impact the department (billing, denials, collections, payments). Recommends revisions to Revenue Cycle Manager.
  • Work collaboratively within the team and other departments
  • Responsible for training staff respective to their individual assigned duties
  • Be a positive role model willing to share knowledge, skills and expertise with other members of the team
  • Provide report details to the Revenue Cycle Manager as required
  • Interview candidates for the team. Approve PTO, perform 30 day, 90 day, and annual reviews; all other supervisory duties for team members
  • Attend and participate in status meetings, as well as lead weekly team meetings
  • Ensure 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 frames
  • Willing to support all members of the team
  • Comply with all HIPAA and privacy regulations
  • Adhere to laws and best practices in regards to dealing with patients and patient data
  • Perform other job-related duties as assigned

Minimum Qualifications (Knowledge, Skills, and Abilities)
  • High School Diploma or GED required, college degree preferred
  • Experience with claim submission, payment posting, appeal and denial processes; minimum 2 years required
  • Experience in medical device billing and/or general healthcare reimbursement, minimum 2 years required
  • Understanding of Medicare and commercial insurance carriers plan configurations in respect to calculations of coinsurance, deductibles and percentages, minimum 2 years required
  • Prior 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 resolutions
  • Excellent problem solving and analytical skills, required
  • Ability to think and work effectively under pressure and accurately prioritize
  • Detail-oriented with the ability to conduct research and identify steps required to resolve issues and follow through to effectuation
  • Ability to prioritize work and analyze workflow deficiencies to improve processes
  • Ability to consistently meet appeals accuracy and timeline requirements by achieving regulatory standards
  • Must have good computer skills, experience with Microsoft Office, required
  • Experience with 10-key calculator
  • Able to communicate clearly, both orally and in writing
  • Able to work effectively with a wide range of people
  • Time management skills
  • Excellent 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, MO
  • Must 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 telephone
  • Must be able to work the scheduled 8 hour shift Monday-Friday
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