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The Accounts Receivable (AR) Team Lead at Riverside Healthcare plays a pivotal role in overseeing all billing and collection activities related to insurance accounts receivable. This position, under indirect supervision, is responsible for the coordination, training, and mentoring of the AR team members, ensuring accurate and timely processing of insurance claims and follow-ups. The AR Team Lead acts as a key resource for all departments within the health system, offering expertise in contracted insurance payers, coding, and fostering a collaborative team environment. This role also emphasizes adherence to patient satisfaction principles and requires the ability to perform additional tasks as assigned and demonstrates flexibility with assignments within professional scope/duties/licensure.

Essential Duties

Team Leadership & Training: Lead, train, and mentor the AR team,

ensuring all members are equipped with the necessary skills and knowledge to perform their duties effectively.

Billing & Collections: Oversee all billing and collection activities

related to insurance accounts receivable, ensuring accuracy and compliance with established procedures.

Claims Management: Handle complex insurance denials, perform root

cause analysis, and implement corrective actions to reduce and prevent future denials. Engage in appeals processes to secure payment resolution.

Process Improvement: Identify and recommend opportunities for

improving customer service, system processes, and overall efficiency. Partner with management to implement necessary changes.

Compliance & Standards: Ensure adherence to HIPAA privacy standards

and compliance with patient health information privacy practices in all communications. Maintain an understanding of evolving payer classifications and reimbursement policies.

Coding & Documentation: Review and resolve coding-related denials,

correcting CPT, ICD-10, and HCPCS codes as needed. Maintain coding compliance and stay updated with recognized coding guidelines and billing requirements.

Collaboration: Actively participate in payer calls, provide feedback

to payer representatives, and escalate issues as necessary. Keep the manager informed of progress, achievements, and any issues that arise.

Productivity & Quality: Run staff productivity, perform monthly

audits, and provide feedback to staff.

Special Projects: Assist with special projects and other duties as

assigned, as necessary.

Continuing Education: Participate in trainings and seminars as

assigned by the Patient Accounting Manager to stay current with industry standards and improve job performance.

Non-essential Duties

Assist with other administrative duties or tasks as assigned by

management.

Support cross-functional teams as needed for comprehensive billing

and collection processes.

Riverside Healthcare

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