Revenue Cycle Lead - Collections

Vital Care Infusion Services•Pittsburgh, PA

18h•$22 - $27•Remote

About The Position

Vital Care is a premier pharmacy franchise business with franchises serving a wide range of patients, including those with chronic and acute conditions. Since 1986, their passion has been improving the lives of patients and healthcare professionals through locally-owned franchise locations across the United States. They have over 100 franchised Infusion pharmacies and clinics in 35 states, focusing on the underserved and secondary markets. This role performs functions to plan for and train Specialist positions, involving initial intake, billing, and collections requirements. The position will cultivate an environment of outstanding customer service as the voice of the company in all interactions with franchise partners, payers, and patients.

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.
Serve as the 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.
Assist the posting department with missing explanations of benefits on time to ensure properly reconciled revenue.
Monitor team activities and work with Reimbursement Specialists 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.

Benefits

Comprehensive medical, dental, and vision plans, plus flexible spending, and health savings accounts.
Paid time off, personal days, and company-paid holidays.
Paid Paternal Leave.
Volunteerism Days off.
Income protection programs include company-sponsored basic life insurance and long-term disability insurance, as well as employee-paid voluntary life, accident, critical illness, and short-term disability insurance.
401(k) matching and tuition reimbursement.
Employee assistance programs include mental health, financial and legal.
Rewards programs offered by our medical carrier.
Professional development and growth opportunities.
Employee Referral Program.