Lead, Accounts Receivable

Job Title:                              Lead, Accounts Receivable

Department:                      Patient Account Services

Location:                             On Site - San Antonio, TX

Reports To:                         Supervisor, A/R

FLSA Status:                       Non-exempt

Summary of Position: 

The Lead, Accounts Receivable is responsible for performing duties in the Insurance Follow-up department (commercial insurance, governmental payors, and private pay). The Lead will provide coverage due to absences and overflow work/projects, and various audits. This position will assist with work plans and ensure all team members are consistently working toward department goals. The Lead must maintain strictest confidentiality at all times.   

Job Responsibilities:

• Employee will adhere to STRG Policy and Procedures at all times
• The Lead must demonstrate proficiency on all payors. He/she must be able to fill in and train an employee for the following positions as needed:
• A/R Specialist
• A/R Specialist Assistant
• Private Pay Collector
• Medical Records Group Bill Coordinator
• Demonstrate proficiency in the preparation of spreadsheets and other documents as requested
• Monitor Collection Queues for trends/outbreaks and take appropriate actions immediately, involving the supervisor as needed
• Audit team members’ work to assure quality and address all issues found
• Review websites and confirm team members using all payor tools and appeal options for better efficiency
• Under direction of Manager, fill in and assist with training for Group Accounts Specialist, including all aspects of the invoicing and follow-up process as outlined in standard procedures
• Maintain thorough knowledge of Practice Management software, insurance sets, insurance codes, and billing logistics
• Demonstrate proficiency in the analysis of data
• Demonstrate proficiency in preparing payment data, contacting payors and resolving any payment discrepancies, payment denials, or delayed payments
• Report any inefficiencies or trends to the supervisor
• Draft procedures to enhance the efficiency of the department
• Prepare and submit prepayment and post payment requests for multiple payors
• Prepare records/documents and assist in the response to audits such as Medicare/CMS, SMRCs, etc.
• Complete special projects as directed by the supervisor
• Process approved adjustments/write-offs
• Provides productivity numbers for department reports
• Analyze and resolve complex accounts, assist A/R Specialists in resolution
• Work inventory including AR Reports, No Response, and denials in Collections Queues
• Work Waystar Systems rejections such as taxonomy, NPI, provider, and other data type issues
• Be responsible for the department in the Supervisor’s absence
• Complete a daily productivity sheet and electronic productivity sheet. These are to be accurate, computed as directed and detailed, covering all aspects of work completed each day
• Track completion of all pending work
• Utilize Outlook/Tickler to schedule follow-up as required (e.g. reissued checks, CSR issues with appeal in process, update requested by supervisor, etc.)
• Maintain strict confidentiality of patient protected health information as mandated by STRG procedures and HIPAA Privacy, Security and HITECH regulations
• Perform other duties as required

Supervisory Responsibilities:

None

Experience / Skill Requirements:

Basic understanding of arithmetic concepts; ability to operate standard office machines including personal computers and 10-key by touch.  At least one year’s experience in a medical office or health insurance company. This person must have the following skills: ability to communicate effectively, orally and in writing; negotiating skills; even temperament; prior training in a medical billing environment.

Education:

High School Diploma or GED

Attendance / Work Schedule:

Maintaining and satisfying minimum attendance requirements is an essential function of this position, including working all full-time regular hours as established for this position and scheduled or emergency overtime. Full-time regular hours are defined as Monday through Friday, with after-hours or weekends as required. All employees in this job classification are required to satisfy this requirement. This job classification does not include "light duty" work or allow unpredictable or unrestricted absences.