Physician Partners of America

  • Collections Team Lead

    Job Locations US-FL-Tampa
    Job ID
    2018-1875
    Category
    Accounting/Finance
    Type
    Full-Time
  • Overview

    Collections Team Lead

     

    Physician Partners of America (PPOA) is a fast-growing integrated health care organization with multi-site ambulatory surgical centers, clinics, pharmacies and laboratories in both Texas and Florida. By just doing what you do best, you’ll be supporting our organization’s overall mission of providing high-quality care and service to our patients.

     

    We are looking for a Collections Team Lead to assist with all functions associated with collections, billing, and third party payers.  This leader will also coordinate efficiencies and maintain revenue integrity related to the revenue cycle duties performed by the Medical Collectors in the team and report to the Associate Director of Revenue Cycle, through the Director of the Pain Practice Division.

     

    Responsibilities

    • Responsible for the day-to-day operations of a collections team while maintaining a designated level of collections by means of payments and guiding denied claims through to payment.
    • Collect outstanding receivables from insurance companies, patients and physicians.
    • Provide excellent customer service by leading and training other collectors.
    • Work in a high volume medical coding and collections environment while maintaining exceptional standards of excellence.
    • Strategic in working with insurance companies, healthcare providers, and patients to get a claim processed and paid on a timely basis.
    • Ensure that the billing and collecting functions proceed in a timely productive fashion.
    • Maximize collections efforts to enhance the overall Accounts Receivable performance.
    • Follow through on denied claims contacting third party payers and patients for timely payment resolution.
    • Ability to accurately review and bill all secondary and tertiary insurances to correct charges, bill forms and supporting documentation (EOBs).
    • Appropriately identify denied claims, wok to ensure that trends are identified and resolved quickly.
    • Assists in training staff in addition and assists in writing and updating current workflow processes and SOPs.
    • Maintain daily billing queues by working and reporting claim edits or following up on claim issues.
    • Good working knowledge of medical practice management systems and EHR with emphasis on billing, coding and collecting processes.
    • Perform daily financial transactions which includes computing, posting, verifying, and recording accounts receivable data
    • Prepare, process and resolve adjustments and payment discrepancies
    • Maintain Aging Report with update status report to management and notifying Account Management of critical accounts.
    • Must be able to recognize and apply priorities internal and external customers.
    • Work independently while maintaining confidentiality and following HIPAA regulations.
    • Manages daily workflow in a production environment and utilizing all available resources to complete daily work assignments in a timely basis.
    • Supports a teamwork environment and participates in required meetings as needed.
    • Regularly attend monthly staff meetings and continuing educational sessions as required.
    • Maintains work operations by following policies, procedures, and reporting compliance issues.
    • Maintains quality results by following standards set forth by the company.
    • Updates job knowledge by participating in educational opportunities, reading professional publications, keeping current on Medicaid/Medicare billing, and reimbursement procedures.
    • Other assigned duties as assigned.

    Qualifications

    • High School diploma
    • At least 5 years of progressive experience in medical coding, billing and collections.
    • Previous years’ experience in pain management clinics and ASCs within an out of network environment is preferred.
    • Some college or certification is preferred.

     

    KNOWLEDGE, SKILLS AND ABILITIES

    • Knowledge of insurance payer requirements as it relates to benefit coverage, referrals and authorizations.
    • Knowledge of processes and methods for maintaining clear and precise notes received from insurance payers related to insurance verification communication with payers
    • Knowledge of clinic policies and procedures.
    • Knowledge of insurance billing and collection guidelines including: HMO/PPO, Medicare, Medicaid, other third party payers, HCPC, CPT, ICD-10 coding and medical terminology.
    • Knowledge of LCDs (Local Coverage Determinations), payer billing guidelines and medical policies.
    • Knowledge working in online payer portals such as: Availity, Navinet, Orthonet, etc.
    • Knowledge of computer systems, programs, data entry, and spreadsheet applications is essential.
    • Working knowledge of MS Office applications including MS Word, PowerPoint and Excel.
    • Excellent analytical skills.
    • Detail oriented self-starter with a strong work ethics.
    • Highly professional, confident conscientious and cooperative attitude.
    • Strong written, verbal communication and organizational skills, as well as excellent customer service skills.
    • Knowledge and understanding of legislation and regulations regarding healthcare practices and CMS regulations.
    • Knowledge of processes and procedures for documenting patient information and HIPAA regulations.
    • Ability to work effectively with medical staff and external agencies
    • Ability to be proactive, self-directing and take initiative.
    • Ability to multi-task and meet deadlines.
    • Ability to work effectively with medical staff, revenue cycle team and external agencies.
    • Ability to identify, analyze, and solve claim issues.
    • Ability to deal courteously and professionally with internal and external customers.
    • Ability to work independently and collaboratively within a team environment.

    Physician Partners of America celebrates diversity and is an Equal Opportunity Employer. We perform background checks and pre-employment drug screens.

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