Collection Lead

Collection Lead

The Medical Insurance Collector Team Lead is required to assist with training new

employees in-house for at least 30 days. Assist teammates with questions, process

improvement, assist with payer issues, assist with team performance, and

motivation of team members. The MIC Team Lead should back management

decisions and assist management when needed. The MIC Team Lead will also

perform collection activities on complex denials and prepare appeals and other

necessary actions on outstanding balances for BCBS, UHC, Aetna/Cigna, and self-funded/commercial providers in the professional/facility fee environment. Our

facilities are out of network with all payers.

To succeed in this role, you must possess patience, a positive attitude, and in-depth

knowledge of collection processes and medical insurance policies. The ideal

candidate must also be able to demonstrate excellent written and verbal

communication skills, as they will communicate with management, employees,

various insurance companies, and customers. This position requires an individual

who can multi-task, problem-solve, and manage time effectively.

Essential Job Functions and Responsibilities:

• Investigates and responds to inquiries from payors
• Research errors and make necessary corrections for clean claim production and submission
• Follow up on accounts to ensure timely filing and prompt payment
• Actively review billing/collection policy changes for assigned payers
• Follow up on payment errors, review posting, and calculate allowable amount before approving patient statements
• Review Insurance EOB and initiate appeals as necessary
• Resolves all insurance requests, inquiries, and concerns in a practical and respectful manner
• Work accounts to ensure payment meets the qualified payment amount required by the No Surprises Act
• Must be able to think outside of the box; critical decision-making is necessary to fulfill the expectations of the position
• Meet and exceed departmental goals set by the company and department manager
• Communicate billing employee issues, strengths, and weaknesses directly to the Billing Manager for review
• Recommend improvements to work methods or procedures
• Confer with other departmental leads to coordinate activities
• Coordinate activities of workers or staff
• Establish and maintain relationships with billing staff

Job Requirements/Qualifications:

• MUST HAVE 5 PLUS YEARS OF MEDICAL INSURANCE COLLECTION EXPERIENCE (REQUIRED).
• Organized, self-sufficient, analytical, and detail-oriented
• STRONG Knowledge of insurance plan providers- BCBS, UHC, Aetna/Cigna, and self-funded/commercial providers required
• Knowledge of Electronic Medical Records, Collections, Payment Posting,
• Reimbursement, Billing, and Hospital Experience
• REQUIRED Knowledge of EOB, HIPAA, ICD-10 codes, and CPT codes
• Knowledge of payer systems
• Computer Savvy
• Team Player, Problem Solver, and Great Communication and Leadership