Remote Underpayments Analyst Jobs (NOW HIRING)

Overview

The Collections Manager will be capable of performing and supervising all activities related to the collection of all Accounts Receivable, including but not limited to, Government, Medicare, Medicaid, and commercial insurances. The Collections Manager will perform all human resource-related tasks associated with the managing of employees. The Collections Manager will work closely with collectors onsite and in other locations and with other management to identify and share information about trends or patterns in payment activity to drive overall Payer collections performance. The Collections Manager will ensure that the Revenue Cycle Management department maintains compliance with company policies and all applicable laws and regulations regarding billing, collections, banking, and the security of patient financial information. Above all, qualified candidates should possess strong problem solving and analytical abilities to drive the highest level of collectability

Responsibilities

Team Leadership & Development:

• Supervises and mentors the Payer Collections Management team
• Conducts regular performance evaluations, provides constructive feedback, and implements development plans to enhance team skills and productivity
• Coordinates and leads team meetings to ensure alignment with company goals and objectives
• Develops and implements training programs to keep the team updated on the latest industry standards and regulatory changes

Revenue Cycle Operations:

• Thinks ahead and builds plans to drive best-in-class Payer Collections performance
• Drives a continuous improvement mindset, leveraging process/technology to drive efficiency across the Payer Collections function
• Manages the process of collections and assists with the receiving, batching, posting, balancing, and archiving payments and adjustments to accounts receivable
• Reviews and approves the posting of adjustments within eligible range of $250.00 and under
• Partners with the Collection Supervisor team to perform research of account balances that exceed $10,000, which are 75 days or greater, to ensure collector managing account is taking appropriate actions to resolve balance by 90 days
• Identifies inefficient processes and makes recommendations to automate or eliminate
• Proactively monitors workload of staff; makes recommendations to management of staffing needs
• Identifies collections pattern such as denials, short-payment, overpayment or non-payment and partners with the collections and operations team(s) to build plans to address root causes
• Addresses and resolves any issues related to claims denials, underpayments, or patient disputes

Compliance & Quality Assurance:

• Ensures that all Payer Collections activities comply with federal, state, and payer-specific regulations
• Collaborates with the compliance team to stay informed about changes in healthcare laws and payer requirements
• Monitors payer websites regularly for updates and communications; accordingly, makes recommendations to changes in billing procedures to insure timely payment of claims
• Performs regular audits of Payer Collections processes to ensure accuracy and compliance

Cross-Functional Collaboration:

• Works closely with finance to evaluate aging AR
• Works closely with external vendors managing portions of the company AR to ensure appropriate results are being delivered
• Works closely with Collections supervisors & HR department to resolve HR related concerns
• Partners with the cash and billing team to reconcile accounts receivable and ensure accurate financial reporting
• Participates in audit and compliance activities to ensure all information is provided to support audit/compliance/legal requests

HR & Administrative Tasks

• Manages HR related tasks related to monitoring and coaching to employee performance
• Assists with onboarding new team members, ensuring they receive the necessary training and resources
• Oversees the distribution of equipment to remote and on-site team members, including coordinating shipments and maintaining inventory of company-provided equipment
• Facilitates regular communication with HR to address team-related issues and ensure compliance with policies and procedures
• Supervisory Responsibility: Yes

Qualifications

EDUCATION/EXPERIENCE
• Bachelor’s degree in healthcare administration, business administration, or a related field strongly preferred but not required.
• Minimum of 5 years of experience in revenue cycle management, preferably within a specialty pharmacy or home infusion setting.
• At least 5 years of supervisory or management experience in a similar role.
• Strong knowledge of healthcare billing, coding, and reimbursement processes, including experience with Medicare, Medicaid, and commercial payers.

KNOWLEDGE/SKILLS/ABILITIES
• Proficient in revenue cycle management software and Microsoft Office Suite.
• Excellent leadership, communication, and problem-solving skills.
• Ability to analyze complex data, identify trends, and implement effective solutions.
• Strong attention to detail and commitment to accuracy and compliance.

Occasional weekend, evening or night work if needed to ensure shift coverage
On-Call as needed basis

**To perform the duties of this position will require typing on a keyboard with fingers, frequently sitting, standing, and walking, as well as occasionally reaching. The physical requirements will be the ability to push/pull and lift/carry 11/20 lbs**