Accounts Receivable Team Lead

The Accounts Receivable (A/R) Team Lead is a hands-on working lead responsible for guiding the daily activities of the A/R and denial follow-up team while maintaining an assigned account workload. The role ensures timely, accurate, and compliant follow-up on unpaid, underpaid, denied, rejected, and aged claims across professional and facility billing. The Team Lead monitors work queues and performance results, coaches staff, identifies root causes and payer trends, coordinates issue resolution, and escalates operational risks that may delay or reduce reimbursement. Success in this position requires strong payer knowledge, sound judgment, consistent follow-through, and the ability to balance team leadership with direct account resolution. The Team Lead serves as the first point of support for workflow questions and helps translate department goals into clear daily priorities. Duties and Responsibilities: Team Leadership and Staff Development Direct daily workflow, assign and rebalance work, communicate priorities, and ensure adequate coverage of assigned payer, location, aging, and denial work queues. Serve as the first escalation point for account-resolution questions, payer follow-up barriers, workflow concerns, and complex claims requiring additional review. Provide structured onboarding, job-specific training, side-by-side coaching, refresher education, and ongoing support to A/R staff. Monitor attendance, availability, schedule adherence, responsiveness, productivity, quality, and professional conduct; document concerns and elevate patterns to the RCM Manager or Director. Conduct routine quality reviews and provide timely, specific feedback; partner with management on performance improvement plans and corrective action when needed. Promote accountability, respectful communication, teamwork, retention, and a solution-focused culture across on-site and remote staff. Lead or participate in team huddles, training sessions, payer reviews, and operational meetings; communicate decisions and follow-up expectations clearly. A/R, Denial, and Payer Follow-Up Operations Maintain an assigned workload and perform timely follow-up on unpaid, underpaid, denied, rejected, and outstanding claims through payer portals, telephone calls, written correspondence, and electronic claim tools. Analyze remittance advice, explanations of benefits, denial codes, claim edits, payer policies, authorization records, eligibility data, coding and documentation to determine the appropriate corrective action. Complete or direct corrected claims, reconsiderations, appeals, medical record submissions, reopening requests, payment variance reviews, and other account-resolution activities within filing and appeal deadlines. Validate contractual adjustments and reimbursement against available fee schedules, payer contracts, and expected reimbursement methodology; elevate suspected underpayments or contract configuration concerns. Research complex account issues, including coordination of benefits, authorization, medical necessity, bundling, coding edits, timely filing, duplicate claims, recoupments, credit balances, and payer processing errors. Ensure every account reflects a clear, accurate, and complete activity note, including action taken, contact details, reference numbers, expected next step, and follow-up date. Identify accounts requiring transfer to another workflow or department and ensure a clear handoff rather than allowing unresolved balances to remain idle. Recommend appropriate disposition of uncollectible or nonrecoverable balances in accordance with approval limits, payer rules, and company adjustment policies. Workflow, Performance, and Continuous Improvement Review dashboards, aging reports, denial work queues, inventory counts, productivity, quality results, collection activity, and unresolved account trends to identify risks and opportunities. Track team progress toward established department goals, including account touches, resolution rates, aging reduction, appeal timeliness, documentation quality, preventable denial trends, and recoveries. Prioritize inventory by age, dollar value, timely filing or appeal risk, payer behavior, denial category, and organizational impact. Investigate recurring denials and reimbursement delays, perform root-cause analysis, and recommend corrective actions involving registration, eligibility, authorization, coding, charge capture, claim submission, payment posting, or payer configuration. Assist with development, testing, implementation, and maintenance of A/R workflows, standard operating procedures, job aids, work queues, automation, reports, and system enhancements. Validate that new or revised processes are adopted consistently and report barriers, training gaps, or unintended workflow consequences to management. Prepare concise operational updates for leadership, including accomplishments, risks, payer trends, staffing concerns, unresolved barriers, and recommended next steps. Compliance, Quality, and Cross-Functional Partnership Perform all duties in accordance with HIPAA, payer requirements, federal and state regulations, company policy, and ethical billing and collection practices. Safeguard protected health information and financial information and access only the minimum information necessary to perform assigned duties. Partner with coding, charge posting, payment posting, credentialing, authorizations, front office, clinical operations, finance, information technology, and other stakeholders to resolve upstream and downstream revenue-cycle issues. Communicate identified documentation or coding concerns through the approved escalation process; do not independently alter clinical documentation or direct coding outside the employee's authorized scope. Support internal and external audits, payer requests, account inventories, acquisition or location integrations, and other department projects as assigned. Maintain current knowledge of Medicare, Medicaid, commercial, managed care, workers' compensation, VA Community Care, and TRICARE billing and appeal requirements applicable to the assigned inventory. Perform other duties and special projects consistent with the position and business needs. Performance Expectations Meets established individual and team productivity, quality, collection, aging, and turnaround-time expectations. Ensures work is prioritized appropriately and completed within payer timely filing, reconsideration, appeal, and documentation deadlines. Maintains accurate account notes and reliable follow-up dates so work is transparent, auditable, and transferable. Addresses performance or workflow concerns promptly, consistently, and professionally; escalates material risks before deadlines or revenue are affected. Demonstrates ownership of assigned work, responsiveness during scheduled hours, sound judgment, and dependable follow-through. Uses reporting and account-level evidence to support recommendations and distinguish isolated issues from systemic trends. You will love it here if you have: High school diploma or equivalent. Minimum of three years of progressive medical billing, insurance follow-up, denial management, underpayment, or healthcare collections experience. Demonstrated ability to lead workflow, coach peers or staff, resolve escalated accounts, and communicate performance expectations. Working knowledge of claim forms, remittance advice, EOBs, denial and remark codes, payer portals, corrected claims, reconsiderations, appeals, timely filing, and reimbursement follow-up. Working knowledge of medical terminology, CPT, HCPCS, ICD-10-CM, modifiers, and common professional and/or facility billing concepts. Proficiency with practice-management or electronic health record systems, clearinghouse tools, payer portals, Microsoft Outlook, Word, and Excel. Strong analytical, organizational, problem-solving, written communication, and verbal communication skills. Ability to manage competing priorities, meet deadlines, maintain confidentiality, and work with a high degree of accuracy and independence. What we need from you: Associate degree or higher in healthcare administration, business, finance, health information management, or a related field. Two or more years of formal or informal team-lead, training, quality-review, or supervisory experience in revenue cycle operations. Experience with eClinicalWorks, Waystar, or comparable EHR, practice-management, clearinghouse, analytics, and denial work-queue platforms. Pain management, ambulatory surgery center, multispecialty, or multi-location revenue cycle experience. Experience interpreting payer contracts or fee schedules and investigating payment variances. Relevant certification such as CRCR, CPB, CPC, COC, CCS, or an equivalent revenue-cycle or coding credential. Working Conditions and Physical Requirements Regularly operates a computer, telephone, scanner, and other standard office equipment and communicates through electronic systems. Must be able to remain in a stationary position for extended periods and occasionally move about the office to access equipment, files, or team members. Must be able to exchange accurate information in person, by telephone, and electronically and review information displayed on screens and documents. Any greater lifting requirement should be reviewed with Human Resources for job-related necessity and accommodation language. Mus be able to lift up to 26 pounds at a time Prolonged periods of sitting at a desk and working on a computer Ability to sit, stand, and walk Travel This is not a travel role. Bi-lingual is preferred! We are an Equal Opportunity Employer EEO AA M/F/Vet/Disability. Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, protected veteran status or disability. #J-18808-Ljbffr Integrated Pain Associates