Lead Representative – Accounts Receivable

Lead Representative – Accounts Receivable

Requirements

• Demonstrates knowledge of financial processes, systems, controls, and work streams.
• Demonstrates experience working collaboratively in a finance environment coupled with strong internal controls.
• Possesses understanding of service level goals and objectives when providing customer support.
• Demonstrates ability to respond to non-standard requests from vendors and customers.
• Possesses strong organizational skills and prioritizes getting the right things done.

Responsibilities

• Provides ongoing leadership and support to team associates to ensure that day-to-day service and production goals are met.
• Assists management in monitoring associates’ goals and objectives daily; motivates and encourages associates to maximize performance.
• Provides ongoing feedback, recommendations, and training as appropriate.
• Assists supervisors in ensuring staff adherence to company policy and procedures.
• Assists supervisors in related personnel documentation as required, necessary, or appropriate.
• Acts as a subject matter expert in claims processing.
• Processes claims: investigates insurance claims; properly resolves by follow-up & disposition.
• Lead and manage escalation projects, addressing complex issues and ensuring timely resolution to maintain optimal account receivables performance and client satisfaction.
• Resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement.
• Verifies patient eligibility with secondary insurance company when necessary.
• Bills supplemental insurances including all Medicaid states on paper and online.
• Oversees appeals and denials management to maximize revenue recovery and minimize financial leakage, ensuring all claims are accurately processed and followed up in a timely manner.
• Manages billing queue as assigned in the appropriate system.
• Investigates and updates the system with all information received from secondary insurance companies.
• Ensures that all information given by representatives is accurate by cross referencing with the patient’s account, followed by using honest judgement in any changes that may need to be made.
• Processes denials & rejections for re-submission (billing) in accordance with company policy, regulations, or third party policy.
• Updates patient files for insurance information, Medicare status, and other changes as necessary or required as related to billing when necessary.

Preferred Qualifications

• 6+ years of experience, preferred
• High School Diploma, GED or technical certification in related field or equivalent experience, preferred
• Proficiency in Microsoft Excel (e.g., pivot tables, formulas), preferred