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Collection Lead / Medical

Collection Lead / Medical

ENGLEWOOD, CO 80112Englewood, CO, US
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Job Description

Job Description

Overview

Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. As one of the most respected Specialty Infusion providers in America, we service thousands of patients nationwide through our growing network of branches and healthcare professionals.

The RCM Ancillary Services Team Lead will be capable of performing all activities related to the tracking and resolving of Amerita’s credit balances, processing incoming / outgoing correspondence, medical records, payer / patient refunds, payer audits, appeals, and providing Revenue Cycle Management (RCM) support. The RCM Ancillary Services Team Lead will be the primary resource for all employees of the RCM Ancillary Services team. The RCM Ancillary Services Team Lead will work closely with the RCM departments, finance, operations, and other team leads to identify and share information about trends or patterns in payment and residual balance activity. The RCM Ancillary Services Team Lead will ensure that the Revenue Cycle Management department maintains compliance with company policies and all applicable laws and regulations regarding billing, collections, credit balances, banking, and the security of patient financial information.

7 : 00a - 3 : 30p Mon - Fri

  • Medical, Dental & Vision Benefits plus, HSA & FSA Savings Accounts
  • Supplemental Coverage – Accident, Critical Illness and Hospital Indemnity Insurance
  • 401(k) Retirement Plan with Employer Match
  • Company paid Life and AD&D Insurance, Short-Term and Long-Term Disability
  • Employee Discounts
  • Tuition Reimbursement
  • Paid Time Off & Holidays

Responsibilities

  • Assists with the daily direction of the RCM Ancillary Services Team consisting of 12-20 employees
  • Assists with the hiring, onboarding, professional development, and performance oversight to include identifying performance issues and coaching employees toward improvement including disciplinary action; assists with the creation of yearly individual performance goals and provides input during yearly performance evaluations
  • Assists the RCM Ancillary Services Manager and RCM Corporate Trainer with the development and implementation of training materials for the RCM Ancillary Services department to include validation and competency
  • Monitors staff workload and makes prompt recommendations of current and future staffing needs to the RCM Ancillary Services Manager
  • Assists staff with improving departmental processes and issue resolution to include coordination with other RCM, finance, contracting, and operational management staff
  • Oversees the processing and accuracy of all incoming / outgoing medical records requests and payer audits
  • Coordinates the processing of refund checks with Amerita’s and PharMerica’s accounts payable departments to include voided, reissue, and escheatment checks; prepares patient refund packets
  • Analyzes aged credit balances and root causes to identify trends to support finance, accounting, and operations; works with RCM analysts to create additional reports as needed
  • Reviews adjustment report to ensure adjustments taken are categorized correctly and within eligible ranges as outlined by Amerita's adjustment policy
  • Revises and implements policies and procedures to ensure best practices are followed; monitors payer websites for updates and communications; makes recommendations to ensure payment retention and / or timely payment of claims
  • Reviews weekly performance / productivity metrics and conducts quarterly audits to ensure individual and departmental goals are met and deficiencies are addressed to minimize revenue adjustments
  • Though this position does not directly supervise employees, the RCM Ancillary Services Team Lead is the initial resource for all employees of the RCM Ancillary Services team
  • Qualifications

  • High School diploma / GED or equivalent required; Associates degree in Business, Accounting, Finance or a related field a plus
  • A minimum of one (1) year of experience in revenue cycle management; supervisory and home infusion experience a plus
  • Working knowledge of Managed Care, Commercial, Government, Medicare, and Medicaid reimbursement; knowledge of automated billing systems and experience with CPR+ and Waystar a plus
  • Working knowledge and application of metric measurements, basic accounting practices, ICD 9 / 10, CPT, HCPCS coding, and medical terminology
  • Solid Microsoft Office skills with the ability to type 40+ WPM
  • Strong verbal and written communication skills
  • Ability to independently obtain and interpret information with a strong attention to detail
  • Ability to adjust to workflow demands and meet specified deadlines
  • Knowledge of state / federal regulations as it pertains to revenue cycle management, a plus
  • Flexible schedule with the ability to work evenings, weekends, and holidays as needed
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    Medical Medical • Englewood, CO, US

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