Sr PAR Collections

PURPOSE AND SCOPE:
The A/R Team Leader is responsible for the daily analysis, verification, collection and resolution of diverse accounts receivable issues within the assigned function(s).  The incumbent serves as a subject matter expert by providing high level analytical and administrative support in compliance with company policies and procedures. The A/R Team Leader provides guidance and leadership to ensure performance in alignment with company goals and objectives.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Utilizes in-depth knowledge of healthcare billing and collection processes to investigate and resolve payment denials and issues to ensure that all charges are billed.
• Investigates and takes the appropriate steps to address and resolve payment denials and incorrectly paid accounts.
• Researches and resolves claims issues contacting the pertinent parties by telephone or insurance website.
• Ensures timely and accurate reimbursement by responding to the appropriate insurance carriers.
• Reviews reports on a daily basis to capture “no response” claims and to follow-up or re-examine claims “until the account is resolved appropriately. Generates detailed reports for manager review.
• Monitors productivity goals of junior staff, ensures assigned accounts are worked within 45 days of bill date. 
• Identifies payer-specific trends that cause increase in A/R aging.
• Reviews the electronic data interchange vendor website for payer claim rejections.  Determines reason for rejection and corrects information.
• Generates and disseminates monthly patient statements.
• Determines if insurance adjustments are due according to particular qualifying criteria/reasons specified in the Standard Operating Procedures (SOP’s) and makes the appropriate insurance adjustment in the billing system.
• Generates Credit Balance reports regularly to resolve credit balances, distribute to the appropriate AR Rep.
• Conducts quality audits to ensure consistent and excellent customer service by junior staff.
• Tracks productivity and quality each month, maintaining metrics.  Regularly informs team members regarding payer updates and team policy and procedural changes.
• Presents all payer and team issues and updates in the weekly leadership meeting
• Other duties as assigned.
• May act as an informal team leader and provides assistance to junior staff with support tasks that require considerable judgment and initiative.
• Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations.
• May escalate difficult/complex issues to supervisor for resolution, as deemed necessary.
• Assist with various projects as assigned by direct supervisor.
• Other duties as assigned.

Additional responsibilities may include focus on one or more departments or locations.  See applicable addendum for department or location specific functions.

PHYSICAL DEMANDS AND WORKING CONDITIONS:

• The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Prolonged sitting at a computer work station. Extensive use of telephone and ability to maintain a focused train of thought while multitasking in the process of investigating billing issues.
• Able to concentrate on detail oriented data for prolonged period of time.
• Able to adjust routine to accommodate departmental needs and goals
• Must be able to lift light objects; retrieve files from cabinets which may involve upward or downward physical mobility.
• Ability to focus on computer monitor for prolonged periods and clearly see data in paper form with small font printing.

EDUCATION:

• High School Diploma required; Associate’s Degree desirable; and Bachelor’s Degree strongly preferred

EXPERIENCE AND REQUIRED SKILLS:  

• 4 – 6 years’ related experience.
• Strong mathematical aptitude. Payment applications experience in a healthcare environment is helpful.  
• Proficient PC skills with strong Microsoft Office knowledge.
• Excellent written and verbal communication skills.
• Strong organizational and time-management skills.
• Attention to detail.
• Positive attitude and team-oriented approach.

EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity

Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.

If your location allows for pay/benefit transparency, please click the link below to request further information on this position.   Pay Transparency Request Form