Collections Manager

POSITION SUMMARY

The Collections Manager will be responsible for overseeing the collections processes to ensure the timely and accurate collection of outstanding accounts receivable from all payers for Pharmacy, Home Infusion and Specialty product lines. Ensures that the team is trained and motivated. Validates the accuracy of the team's work and ensures that performance goals are met. The role requires a deep understanding of medical billing practices, strong leadership skills, and ability to implement effective startegies for optimizing the collections process. Responsible for problem solving issues with high dollar AR accounts, managing productivity and assigning daily collection tasks to staff. Interfaces with a variety of internal and external customers to ensure the best patient experience in the most efficient manner. Ensures that all HIPAA, policies/procedures and compliance requirements are met within the department.  
REQUIRED KNOWLEDGE, SKILLS & TRAINING

• Minimum 5 years of experience in patient accounts, Benefit Verification and/or collections with specialty pharmacy experience
• Knowledge of NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies
• Maintains a broad range knowledge of insurance plans, medical terminology, billing procedures, government regulations, and HCPCS billing codes
• Demonstrates knowledge of Microsoft Outlook/Excel and Word using them effectively in performing job duties
• Familiar with the authorization process, appeal process and other processes/procedures integral to AR collection efforts
• Able to multitask and utilize excel in a fast-paced working environment 
• Able to problem solve and assist coworkers through the thought process of solving problems
• Collaborate on best practices for efficiency and streamline communication throughout teams
• Minimum of 2 to 3 years of previous experience in a supervisory role required

ESSENTIAL JOB DUTIES

• Manage and lead a team of medical collection specialists. Provide guidance, training, and support to ensure team members meet performance targets. Foster a positive and collaborative work environment.
• Responsible for annual performance reviews. Monitor and analyze performance indicators (KPIs) related to collections. Implement corrective actions to address performance gaps and enhance overall team efficiency.
• Develop and implement effective collections strategies to maximize revenue recovery. Analyze trends, identify root causes of collection issues, and propose solutions for improvement. 
• Assigns accounts and works with management to review open A/R and look for payer trends.
• Responsible for helping to develop policies and procedures and process improvement strategies within the department. Communicates procedure changes to departments affected by that change.
• Able to trouble shoot and resolve escalated collection issues while monitoring and reporting payment trends to senior management. Collaborate with the billing team to address billing discrepancies and resolve issues impacting collections. Ensure accurate and timely submission of claims to insurance providers. Stay informed about changes in healthcare regulations and billing requirements. Ensure compliance with relevant laws, regulations, and industry standards.
• Identifies short payments, over payments, unpaid claims, and resolves accordingly. Reviews residual balances after payments are applied and generates necessary adjustments, overpayment notification, refund requests. Generate and analyze reports on collections performance for presentation to senior management. Provide insights into trends, challenges, and opportunities for improvement.
• Ability to work remotely with minimal supervision. Establish and maintain effective communication channels with staff, healthcare providers and address billing and collections concerns. Work collaborative to resolve disputes and optimize billing processes.
• Ability to be flexible and assist with other projects when needed.

EMPLOYEE BENEFITS

• BCBSL Medical
• Delta Dental
• EyeMed Vision
• 401k
• Accident & Critical Illness
• Life Insurance
• PTO, Holiday Pay, and Floating Holidays
• Tuition Reimbursement