Medical Collections Lead

Amerita

Amerita, Inc. is a leading provider in Home Infusion therapy. We are looking for a Collection Group Leader to join our Revenue Cycle Management team as we grow to be one of the top home infusion providers in the country. As a core member of the Collection team, you will be expected to perform and monitor all activities related to the collection of all Accounts Receivable, including but not limited to Medicare, Medicaid, commercial insurances and patient balances. The Collection Group Leader will report to the Collection Manager.

NOTE: This position is REMOTE (work from home).

Amerita is an entrepreneurial-founded company and a wholly owned subsidiary of PharMerica. The home infusion market is positioned for rapid growth driven by the aging population, increase in chronic diseases, robust pipeline of infusible drugs coming to market, and an industry shift from hospital delivery settings to lower-cost, high-quality alternative providers such as Amerita.

* Medical, Dental & Vision Benefits plus, HSA & FSA Savings Accounts
* Supplemental Coverage - Accident, Critical Illness and Hospital Indemnity Insurance
* 401(k) Retirement Plan with Employer Match
* Company paid Life and AD&D Insurance, Short-Term and Long-Term Disability
* Employee Discounts
* Tuition Reimbursement
* Paid Time Off & Holidays

As a Collection Group Leader, you will...

Ensure that daily accomplishments work towards company goals for cash collections and Accounts Receivable over 90 days.
• Assist the process of collections as well as assist with the receiving, batching, posting, balancing and archiving payments and adjustments to accounts receivable.
• Ensures collection department complies with established company criteria for timeliness and accuracy of billing and collections.
• Research outstanding balances and takes necessary collection action to resolve in a timely manner; makes necessary demographic changes to patient accounts to insure future collections.
• Utilize most efficient resources to secure timely payment of open claims or invoices; electronic solutions should be given priority.
• Review insurance remittance advices for accuracy. Identify billing errors, short payments, over payments, unpaid claims, and resolves accordingly communicating any needed system changes.
• Review residual account balances after payments are applied and generates necessary adjustments (within eligible guidelines), overpayment notification, refund request, and/or secondary billing as needed.
• Monitor payer websites regularly for updates and communications accordingly; makes recommendations to changes in billing procedures to insure timely payment of claims.
• Review and Post adjustments within eligible range of $150.00 and under.
• Identify inefficient processes; makes recommendations to automate or eliminate.
• Identify patterns of short-payment, overpayment or non-payment and brings them to the attention of appropriate specialist.
• Perform Quality Assurance audits for proper management of A/R and evaluation of collector performance.
• Contact payers by telephone, mail, email or other appropriate means to secure copies of missing remittance documents as needed.
• Monitor the adherence to state and federal regulations, to company policies regarding compliance, integrity, patient privacy and ethical billing and collection practices.
• Assist in implementation of training program for Collection Specialists and Patient Collection Specialists.
• Coordinate and conduct training for all new staff.
• Assist with competency testing for all training materials.
• Interact with third party collection agencies as needed.
• Understand and adheres to HIPAA and PHI guidelines.
• Communicate clearly and professionally, both in written form and orally, with internal and external customers.
• Available to work extended hours when necessary to meet department deadlines.

• High School Diploma/GED or equivalent required; Associate's degree in Business, Accounting or Finance a plus
• A minimum of 3 years of experience in medical billing (2 years of experience at Amerita is acceptable) and working knowledge of Managed Care, Commercial Insurance, Medicare and Medicaid reimbursement, and Cash Applications
• Home infusion industry experience a plus
• Solid Microsoft Office skills required; Word, Excel and Outlook
• Strong verbal and written communication skills
• Ability to independently obtain and interpret information
• Knowledge of CPR+ software a plus
• Working knowledge of managed care, commercial insurance, Medicare and Medicaid preferred but not required