Billing Collection Lead

Billing And Collection Lead

Primary City/State: Deer Valley - 2500 W Utopia Rd Phoenix, AZ 85027

Category: Billing and Revenue Cycle

Shift: Day

Department: Patient Financial Services

M-F 6:30 am to 3:00 pm

Mostly remote with some mandatory on-site meetings.

Must reside in the greater Phoenix metro area.

Great care starts with great people. (Like you.)

At HonorHealth, you'll find something special. From humble beginnings in 1927 to one of Arizona's largest nonprofit healthcare systems, our culture is built on warmth and neighborly kindness. Behind every smile is a highly skilled professional with deep expertise and an unwavering dedication to what matters most caring for the health and well-being of people and communities across the greater Phoenix area.

Responsibilities

Billing and Collection Lead serves as a resource for the billing and collections staff. Assist staff in billing and/or collection on problem accounts for Commercial and Government payers. Leads special billing, rebill and/or collections projects. Researches complex billing edits, claim errors or collections patient account errors utilizing various computer applications and software. Monitors daily billing imports, exports and balancing, including review of unbilled, claims errors, and clean claim rates and/or collections activity. Reviews daily productivity of the staff and meets with staff to review. Familiar with a variety of the field's concepts, practices, and procedures. Relies on extensive experience and judgment to plan and accomplish goals. Must have advanced knowledge of CMS and Payer billing requirements, with ability to research and respond to new initiatives.

Essential Functions

• Performs timely follow-up on patient accounts and collection activities normally found in the more problem accounts. Reconciles explanation of benefits to contract terms and files appeals for denials.
• Leads and serves as a resource for fellow employees in regards to patient accounts and collection matters. Assists in development and provides ongoing training to collections and patient accounts employees.
• Creates and manages/maintains reports across different platforms to assist management, improve billing process and identify issues in our internal processes. Maintains daily claims reconciliation and balances claims from patient accounting system to 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 in order to enhance communications, and relations skills. Participates in process improvement activities. Performs other related duties as assigned or requested.

Education

• High School Diploma or GED Required
• Other / Certificate Post high school education, to include, but not limited to accounting courses or medical business office certificate program. Preferred

Experience

• 2 years Commercial contract and Medicare reimbursement collection experience Required or
• 2 years Commercial and Medicare regulatory billing experience Required or
• 5 years Commercial contract and Medicare reimbursement collection experience Preferred
• 5 years Commercial and Medicare regulatory billing experience Preferred