Billing Collection Lead

HonorHealth•Phoenix, AZ

1d•Hybrid

About The Position

The Billing and Collection Lead serves as a resource for the billing and collections staff, assisting them with problem accounts for Commercial and Government payers. This role also leads special billing, rebill, and/or collections projects. The Lead researches complex billing edits, claim errors, or collections patient account errors using various computer applications and software. They monitor daily billing imports, exports, and balancing, including reviewing unbilled claims, claims errors, clean claim rates, and collections activity. Additionally, the Lead reviews daily staff productivity and meets with staff to discuss performance. The position requires advanced knowledge of CMS and Payer billing requirements and the ability to research and respond to new initiatives. Familiarity with a variety of the field's concepts, practices, and procedures is expected, relying on extensive experience and judgment to plan and accomplish goals.

Requirements

High School Diploma or GED Required
Post high school education, to include, but not limited to accounting courses or medical business office certificate program.
2 years Commercial contract and Medicare reimbursement collection experience Required
2 years Commercial and Medicare regulatory billing experience Required

Nice To Haves

5 years Commercial contract and Medicare reimbursement collection experience Preferred
5 years Commercial and Medicare regulatory billing experience Preferred

Responsibilities

Performs timely follow-up on patient accounts and collection activities for problem accounts.
Reconciles explanation of benefits to contract terms and files appeals for denials.
Leads and serves as a resource for fellow employees regarding patient accounts and collection matters.
Assists in the development and provides ongoing training to collections and patient accounts employees.
Creates and manages/maintains reports across different platforms to assist management, improve billing processes, and identify internal issues.
Maintains daily claims reconciliation and balances claims from the patient accounting system to the billing system and back to the Epic dashboard.
Maintains current knowledge of regulatory billing requirements for Medicare Parts A, B, and DME, State Medicaid claims, and other payers' edits and requirements.
Attends payer in-services and departmental meetings to enhance communication and relations skills.
Participates in process improvement activities.
Performs other related duties as assigned or requested.