AR Lead

• Research accounts and identify aged pending claims initiating the necessary corrective action. Identify potential errors, making necessary corrections and refiling claims. Follows up with appropriate office staff to resolve outstanding queries for additional documentation or diagnosis information.
• Performs routine follow-up of selected payers to identify accounts requiring follow-up or patient contact in order to secure payment. Maintain acceptable account receivable days.
• Identifies and tracks trends with payers and reports findings to direct manager. Reports back to the direct supervisor any trends in denials and contributes to denial management.
• Maintains a working relationship with the Revenue Integrity Manager to report back any denials resulting from charge entry with any necessary corrections. Notifies management in changes of workload to maximize productivity.
• Notates accounts worked within the PM system outlining the findings and the resolution for maximum reimbursement. Resolves and follows up on challenging, problematic, and unresponsive accounts as necessary; escalates critical or ongoing issues to managers. Documents all activity on patient accounts.
• Acts as a liaison between practices and the CBO answering practice questions and delegating to the appropriate staff member. Acts as back up for the Revenue Cycle Operations Manager for the morning EDI Process. Fill in for staff members in their absence to help maintain workload.
• Mentors and facilitates improvement efforts with team members to highlight their impact on Riverview’s overall success. Helps with continuing education of AR staff. Helps to train all incoming MA’s, MOS and nursing staff on the PM system during new employee orientation. Responsible to answer staff questions.
• Helps to communicate changes in processes and procedures. Assist in reviewing updating policies and procedures. Identifies improvement opportunities and contributes to the testing of system modifications.
• Maintains skill level by reading bulletins, newsletters, or attending continuing education workshops.
• Other duties as assigned

• Minimum: High School Diploma or equivalent
• Preferred: Medical certification program in healthcare or Certified Professional Biller (CPB)

• Minimum: 5 years of accounts receivable experience in healthcare working in a medical billing office.
• Preferred: 7 or more years of experience working in healthcare in medical billing, insurance, collections, claims processing, and coding or working within a hospital business office.

Riverview Hospital