Collection Lead

Nutex Health, Inc; United States; On-site; USD 60,000 - 90,000; Full time

Job summary

Nutex Health, Inc. seeks a Collection Lead to supervise the Medical Insurance Collector Team, train new staff, and resolve complex payer issues. The role involves mentoring teammates, supporting management, and driving performance across BCBS, UHC, Aetna/Cigna, and self-funded providers in professional/facility billing.

Strong communication and multitasking are essential. Out-of-network facilities and a focus on patient statements require thorough knowledge of insurance policies and denial

Qualifications

• Must have 5+ years of medical insurance collection experience.
• Organized, self-sufficient, analytical and detail-oriented.
• Strong knowledge of BCBS, UHC, Aetna/Cigna and self-funded providers.
• Knowledge of EMR, collections, posting, reimbursement, billing and hospital experience.
• Excellent written and verbal communication; able to lead and mentor a team.

Responsibilities

• Investigate and respond to payer inquiries and issues.
• Research errors to ensure clean claim submission.
• Follow up on accounts to ensure timely filing and payment."
• Review policy changes for assigned payers and adjust processes.
• Review EOBs and initiate appeals when needed.
• Coordinate with billing staff and lead team to meet goals.

Skills

Medical insurance collections

Team leadership

Communication

Problem solving

Time management

Tools

EMR systems

Billing software

Job description

Collection Lead

Collection Lead The Medical Insurance Collector Team Lead is required to assist with training new employees in-house for at least 30 days. Assist teammates with questions, process improvement, assist with payer issues, assist with team performance, and motivation of team members. The MIC Team Lead should back management decisions and assist management when needed. The MIC Team Lead will also perform collection activities on complex denials and prepare appeals and other necessary actions on outstanding balances for BCBS, UHC, Aetna/Cigna, and self-funded/commercial providers in the professional/facility fee environment. Our facilities are out of network with all payers. To succeed in this role, you must possess patience, a positive attitude, and in-depth knowledge of collection processes and medical insurance policies. The ideal candidate must also be able to demonstrate excellent written and verbal communication skills, as they will communicate with management, employees, various insurance companies, and customers. This position requires an individual who can multi-task, problem-solve, and manage time effectively.

Essential Job Functions and Responsibilities

• Investigates and responds to inquiries from payors
• Research errors and make necessary corrections for clean claim production and submission
• Follow up on accounts to ensure timely filing and prompt payment
• Actively review billing/collection policy changes for assigned payers
• Follow up on payment errors, review posting, and calculate allowable amount before approving patient statements
• Review Insurance EOB and initiate appeals as necessary
• Resolves all insurance requests, inquiries, and concerns in a practical and respectful manner
• Work accounts to ensure payment meets the qualified payment amount required by the No Surprises Act
• Must be able to think outside of the box; critical decision‑making is necessary to fulfill the expectations of the position
• Meet and exceed departmental goals set by the company and department manager
• Communicate billing employee issues, strengths, and weaknesses directly to the Billing Manager for review
• Recommend improvements to work methods or procedures
• Confer with other departmental leads to coordinate activities
• Coordinate activities of workers or staff
• Establish and maintain relationships with billing staff

Job Requirements/Qualifications

• MUST HAVE 5 PLUS YEARS OF MEDICAL INSURANCE COLLECTION EXPERIENCE (REQUIRED).
• Organized, self-sufficient, analytical, and detail-oriented
• STRONG Knowledge of insurance plan providers- BCBS, UHC, Aetna/Cigna, and self-funded/commercial providers required
• Knowledge of Electronic Medical Records, Collections, Payment Posting, Reimbursement, Billing, and Hospital Experience REQUIRED
• Knowledge of EOB, HIPAA, ICD-10 codes, and CPT codes
• Knowledge of payer systems
• Computer Savvy
• Team Player, Problem Solver, and Great Communication and Leadership

Nutex Health is the premier innovative service provider in the emergency care industry. Our specialists provide unparalleled expertise with the knowledge and competency to make your vision a reality. You can trust Nutex Health to deliver a turnkey process from real estate acquisition, design, and development of the ER facility to staffing, training, and operations.

Nutex Health is committed to providing equal employment opportunity and all qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, status as a protected veteran, or membership in any other class protected by federal, state, or local law.

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