Description:
About Our Company
Advanced Diabetes Supply® was founded on the bold principle of creating a knowledgeable, reliable and demonstrably superior diabetes supply company. Our approach, coupled with a commitment to service and innovation, has catapulted Advanced Diabetes Supply® to a national leader in the industry. Creating high-performance, adaptive teams requires a relentless commitment to hiring the best. We strive to maintain a casual, fun environment whenever possible, but we don't just play around. We work hard every day to provide a positive work culture and respectful atmosphere. The standards we set for ourselves are high, and we love to be challenged! If you enjoy working in a collaborative environment, have a passion for excellence and a bias for action, we may be just what you've been looking for.
Interested in learning more about our company and its culture? Visit us at www.northcoastmed.com
About the Position
The NCMS Accounts Receivable Team Lead performs day-to-day AR functions with the goal of ensuring that all policies and procedures related to providing consistent, supervisor customer/patient care are adhered to, and service & production goals are met effectively and efficiently. They will work within the scope of responsibilities as dictated below with guidance and support from AR & Billing leadership teams.
Essential Functions
- Provides ongoing support to team to ensure that day-to-day service and production goals are met.
- Assists management in monitoring associates' goals and objectives daily; motivates and encourages associates to maximize performance.
- Provides ongoing feedback, recommendations, and training as appropriate.
- Assists supervisors in ensuring staff adherence to company policy and procedures.
- Assists supervisors in related personnel documentation as required, necessary, or appropriate.
- Acts as a subject matter expert in claims processing.
- Processes claims: investigates insurance claims; properly resolves by follow-up & disposition.
- Lead and manage escalation projects, addressing complex issues and ensuring timely resolution to maintain optimal account receivables performance and client satisfaction.
- Resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement.
- Verifies patient eligibility with secondary insurance company when necessary.
- Bills supplemental insurances including all Medicaid states on paper and online.
- Oversees appeals and denials management to maximize revenue recovery and minimize financial leakage, ensuring all claims are accurately processed and followed up in a timely manner.
- Manages billing queue as assigned in the appropriate system.
- Investigates and updates the system with all information received from secondary insurance companies.
- Ensures that all information given by representatives is accurate by cross referencing with the patient's account, followed by using honest judgement in any changes that may need to be made.
- Processes denials & rejections for re-submission (billing) in accordance with company policy, regulations, or third party policy.
- Updates patient files for insurance information, Medicare status, and other changes as necessary or required as related to billing when necessary.
- Maintains accurate and detailed notes in the company system.
- Adapts quickly to frequent process changes and improvements.
- Is reliable, engaged, and provides feedback as to improve processes and policies.
- Attends all department, team, and company meetings as required.
- Appropriately routes incoming calls when necessary.
- Meets company quality standards.
- Embraces and exemplifies ADS core values:
We put our people first.
We serve our members with passion.
We take ownership.
We pursue excellence.
We never stop growing.
- May perform any additional responsibilities or special projects as required.
- Duties and responsibilities may be subject to change based upon the needs of the department.
- May provide cross-functional support as business needs demand.
Requirements:
- High School diploma or equivalent
- 3 years' experience with insurance billing and processing claims
- 3 years' experience with Medicaid claims, and Medicaid and private insurance verification
- Knowledge of insurance portals; familiarity with a variety of medical and/or insurance terms or practices
- Full knowledge all areas of collections specialization
- Proficiency in basic math and business calculations
- Working knowledge of computer/data entry with the ability to learn new systems
- Basic level of MS Office proficiency
Expected Competencies
- Friendly, professional, and effective communications skills; able to calmly present solutions in challenging situations.
- Proactive identification of challenges, and solution-oriented approach to problem solving.
- Service-orientation and aptitude to aptitude to resolve insurance and/or patient matters.
- Effective analytical skills: able to use inductive and deductive reasoning to anticipate outcomes.
- Self-directed accountability and reliability
- Effective communication, and interpersonal skills, with the ability to influence and collaborate effectively with cross-functional teams.
- Cross-trained on all collections processes
- Able to resolve highly escalated collections issues or concerns
- Able to mentor and train as needed
- Able to manage and prioritize multiple tasks/projects, work autonomously, and meet deadlines.
- Able to work well in a team environment that promotes inclusiveness and communication among team members.
- Communication using both verbal and written English proficiency.
- Cultural competence
Physical Demands
The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable employees with disabilities to perform the essential functions.
While performing the responsibilities of the job, the employee is required to remain in a stationary position most of the time (stand or sit). While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is frequently required to stand, walk and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.
Equal Opportunity Statement
Advanced Diabetes Supply provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training
Pay range and Compensation Package
Salary ranges may vary depending on location. Actual compensation depends on education, experience and relevant skills.
Benefits for the full time employees include
- Health, Dental & Vision options
- FSA and HSA plan with Employer Contribution
- Employer paid EAP
- 401k with 4% Company Match
- Discretionary Profit Sharing Plan
- Paid Time Off (PTO) Including 8 Paid Holidays and a Birthday Holiday
- In-house Training Programs
- A fun culture in a fast-growing organization
PM21
PI11e618d9a4b4-25826-34705086
