Medical Insurance Collections Team Lead

Description

• Submission of escalated appeals
• Follow up on high complexity accounts
• Staff training, feedback, and education on payer trends, policies, procedures, and system functionality
• New hire training
• Develop relationships with third party payers/representatives essential to the claims resolution process
• Creation, distribution, and monitoring of reports distributed to staff
• Perform monthly Quality Assurance reviews and meet with each staff member to review results
• Investigate and examine source of rejects and denials utilizing knowledge of ICD-10 coding, CPT coding and EDI billing
• Read and interpret expected reimbursement information from EOB's and learns legal parameters for State and Federal Laws pertaining to the plan benefits
• Coordinate development and ongoing review/revision of Standard Operating Procedure (SOP) affecting RCM
• Meet with office management to communicate focus areas to reduce AR days
• Daily review and approval of write offs
• Basic supervision of staff
• Answer escalated level inquiries from practices and collectors
• Review all high dollar refund requests prior to submission to accounting
• Monitor payer websites and provide pertinent payer updates to staff, managers, and other departments as needed
• Consistent monitoring of payer portals to ensure requested information is submitted timely
• Assist with Medicare and other payer audit requests
• Follows HIPAA guidelines in handling patient information.

• High School Diploma or equivalent required.
• Computer skills that include a combination of experience in a Windows Operating System, e-mail, and data entry experience.
• Prior experience with medical billing software is preferred but not required.
• Three to five years in insurance billing required.
• Excellent judgment, dependability, and conscientiousness.
• Demonstrated high ethical standards and integrity.
• Demonstrated attention to detail.
• Demonstrated accuracy and thoroughness; monitors own work to ensure quality.
• Customer and patient service orientation: prompt response to patient needs and ability to manage difficult or emotional customer situations with tact, empathy and diplomacy.
• Ability to work cooperatively in group situations; offers assistance and support to coworkers, actively resolves conflicts, inspires trust of others, and treats patients and coworkers with respect.
• Patient centered care focused, and a team player.
• Handles multiple tasks effectively and efficiently and exhibits commitment to effective problem-solving techniques when issues arise.
• Continuously acts to maintain a safe, clean, healthy, and fun work environment consistent with AVP’s Mission and Vison.
• Arrives on time, ready to work, and demonstrates minimal absenteeism.
• Demonstrates effective problem-solving skills
• Knowledgeable of Medicare and Medicaid billing and reimbursement concepts and principles.
• Willingness to submit to a background check

We’ve got you covered in more ways than one! As a full-time employee, you receive medical, dental, vision, a 401k plan, long-term disability, and life insurance. Pay is determined based on qualifications and experience. You will also get:

• Paid vacation and holidays (+ two floating holidays)
• Tuition reimbursement opportunities
• Referral bonus opportunities
• Discount on designer eyewear
• Paid certified accreditation program

· Exerting up to twenty-five pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.

· Repetitive motion. Substantial movements (motions) of the wrists, hands, and/or fingers.

· Must have close visual acuity to perform an activity including viewing a computer terminal, extensive reading, interpretation, etc.

· Must be able to be stationary for prolonged periods of time.

· Executes tasks independently.

· Learns and memorizes tasks.

· Maintains concentration/focus on tasks.

· Performs task in a demanding environment requiring multi-task and prioritize work.

· Must be comfortable working and interacting with large groups of people daily.

Compliance training and testing is required annually and as needed.

Atlantic Vision Partners provides equal employment opportunities and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.