Revenue Cycle Lead - Collections

Vital Care Infusion Services•Pittsburgh, PA

4d•Remote

About The Position

Recognized as a “Best Place to Work Modern Healthcare” – Join a team where people come first. At Vital Care, we are committed to creating an inclusive, growth-focused environment where every voice matters. Vital Care ( www.vitalcare.com ) is the premier pharmacy franchise business with franchises serving a wide range of patients, including those with chronic and acute conditions. Since 1986, our passion has been improving the lives of patients and healthcare professionals through locally-owned franchise locations across the United States. We have over 100 franchised Infusion pharmacies and clinics in 35 states, focusing on the underserved and secondary markets. We know infusion services, and we guide owners along the path of launch, growth, and successful business operations.

Requirements

High school diploma or equivalent is required.
2-3 years of experience is required in an infusion setting.
Working knowledge of all Vital Care systems, including CareTend and the RCM Portal.
Knowledge of Payer Compliance.
Highly effective communicator with superior listening, understanding, speaking, and writing skills.
Solid business knowledge and ability to analyze data to identify actions to be taken.
Lead by example and strong team-building skills, with the ability to influence, lead, teach, train, counsel, and coach to accomplish organizational goals.
Ability to identify training requirements and develop and implement training models to improve results.
Demonstrated knowledge of current pharmacy applications and MS Office software, including strong Excel proficiency.
Strong customer service and leadership skills to develop a customer-centric culture and instill ownership of the customer/patient experience.
Ability to foster care and compassion for the patients while instilling price to exceed performance objectives.
Ability to work collaboratively across functional teams and manage projects.
Analytical skills and business acumen demonstrated through proven problem-solving and the ability to exercise solid professional judgment in analyzing business issues and exploring options for resolution.

Responsibilities

Train the team in processing new patient referrals, investigating and verifying insurance benefits, prior authorizations, billing, and collections.
First level of review for items being escalated to outside departments and other Revenue Cycle Leadership.
Review A/R adjustment forms to the maximum level allowed.
Assist in reviewing payer refunds and/or cost refunds when requested.
Track the distribution of workloads, conduct ongoing needs assessments to identify staffing opportunities, and report those to the Revenue Cycle Supervisor.
Serve as the team's primary escalation agent to resolve franchise partner or patient complaints.
Report complaints to the Revenue Cycle Supervisor to provide continuous feedback to the Reimbursement Specialist.
Cultivate an environment of customer service orientation through training and mentoring staff in customer service and collection techniques.
Assisting the posting department with missing explanations of benefits on time to ensure properly reconciled revenue.
Monitor team activities and work with Reimbursement Specialist to provide guidance, training, and improved skills in patient insurance billing, collections, benefits investigation, and insurance authorizations.
Monitor team results to evaluate compliance with quality and productivity expectations and identify improvement opportunities.
Work alongside the Revenue Cycle Supervisor to actively identify payer issues and perform process analysis to ensure effective intake/billing/collection efforts.
Review denial trends to implement training and clean claim turnaround time.
Evaluate performance and provide counseling, cross-training, and coaching to associates.
Maintain mutually respectful employer relations.
Perform other related duties as assigned.