Lead Accounts Resolution Rep

Wellstar Health System; Palmetto (GA); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player in healthcare is seeking a Lead Accounts Resolution Rep to oversee a significant accounts receivable portfolio. This role involves training staff, ensuring compliance with payer timelines, and driving continuous improvement in revenue cycle processes. The ideal candidate will possess strong analytical and interpersonal skills, with a proven track record in hospital financial services. Join a dynamic team dedicated to optimizing operations and delivering exceptional service in a fast-paced environment where your contributions will directly impact the organization's success.

Qualifications

• 3+ years in hospital patient financial services with a strong understanding of healthcare revenue cycle.
• Certifications such as CPAR or Advanced CPAR are strongly preferred.

Responsibilities

• Lead and direct Follow-Up staff, managing daily operations and optimizing workflows.
• Collect and resolve insurance payments, research claim denials, and appeal denied accounts.

Skills

Interpersonal Skills

Analytical Skills

Problem-Solving Skills

Computer Skills

Leadership

Education

High School Diploma

Bachelor's Degree

CPAR Certification

Advanced CPAR Certification

Tools

Epic

Emdeon Claims Master

MS Word

MS PowerPoint

MS Excel

Job description

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Job Summary

Under the direction of the Manager of Account Resolution, the Lead assists with planning and coordinating all HB Accounts Resolution department activities for an account receivable portfolio of approximately $375M-$500M. Responsibilities include training employees, ensuring accounts are reviewed, appealed, escalated, or adjusted within designated payer time frames, documenting appropriately in the patient accounting system, and supporting continuous improvement. The role requires data analysis, trending analysis, workflow design, and departmental educational capabilities regarding payor and revenue cycle processes.

Facility

VIRTUAL-GA

Core Responsibilities and Essential Functions

• Lead and direct the Follow-Up staff, managing daily operations, evaluating trends, optimizing workflows, and resolving issues.
• Provide training, recognition, and evaluation to foster a productive team environment.
• Set strategic and short-term goals, monitor staff productivity, and ensure policies are followed.
• Review and improve work procedures for efficiency.
• Monitor progress using productivity reports and provide feedback.
• Assist with departmental projects and maintain a positive team attitude.
• Resolve complaints tactfully and handle difficult situations fairly.
• Maintain proficiency in automated systems such as Epic and Emdeon Claims Master.
• Review write-off requests and miscellaneous cash adjustments for approval.
• Ensure timely resolution of review requests and completion of audits.
• Collect and resolve insurance payments, research and resolve claim denials, and successfully appeal denied accounts.
• Participate in and support various Revenue Cycle committees and initiatives.
• Maintain knowledge of legal and compliance issues, including HIPAA and reimbursement regulations.
• Develop and update insurance follow-up policies and procedures.

Minimum Education and Certifications

High school diploma or equivalent required; Bachelor's degree preferred. Certifications such as CPAR or Advanced CPAR are strongly preferred.

Experience

At least 3 years in hospital patient financial services or related area, with a thorough understanding of healthcare revenue cycle functions, regulations, and successful performance history.

Skills and Abilities

Strong interpersonal, analytical, computer, and problem-solving skills. Ability to lead, work independently, prioritize, and adapt to change. Proficiency in MS Word, PowerPoint, and Excel is required.

Additional Requirements

Ability to establish performance standards, work under pressure, operate a computer, apply management techniques, and demonstrate a commitment to continuous learning.

Employment Details

• Seniority level: Not Applicable
• Type: Full-time
• Function: Sales and Business Development
• Industry: Hospitals and Health Care