Collections Lead (Hybrid)

POSITION SUMMARY

The Collections Lead is responsible for directing the team that manages all collections functions from payers and patients after claims have been processed. This role requires an in-depth understanding of the denial appeals process, strong negotiation skills, and a strategic approach to recovering outstanding balances efficiently and compliantly.

ESSENTIAL RESPONSIBILITIES AND DUTIES INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING

Leads and mentors the collections staff, defining daily workflow, providing performance coaching, and ensuring all collection activities meet productivity and compliance targets. Develops and executes strategic plans for collecting outstanding balances from Medicare, Medicaid, commercial payers, and self-pay patients, focusing on the oldest and highest-dollar accounts. Oversees the complex process of researching, appealing, and resolving all payment denials efficiently, ensuring all necessary documentation (e.g., medical records, authorization) is included to overturn the denial. Serves as the primary point of contact for high-level communication with payer representatives to negotiate payment and resolve complex, systemic payment discrepancies. Directs the process for patient financial counseling and collections, ensuring all communication is professional, empathetic, and compliant with FDCPA (Fair Debt Collection Practices Act) guidelines. Tracks, analyzes, and reports on key collections metrics, including denial rates, collection effectiveness, and trends in non-payment to identify areas for improvement in upstream processes (Intake, Authorization, and Billing). Other appropriate services and special projects as assigned. The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

QUALIFICATIONS & REQUIREMENTS FOR THE POSITION

At least three (3) years of experience in healthcare collections, accounts receivable follow-up, or denial management, with experience in home health or hospice preferred. At least one (1) year of leadership or supervisory experience managing a collections team. Deep, demonstrable understanding of the Medicare and Medicaid appeals process (e.g., Redetermination, Reconsideration). Proven ability to interpret Explanation of Benefits (EOBs), remittance advices, and payer contracts. Proficiency in using collection management modules within major EMR systems.

Job Type:

Full-time Expected hours: 40 per week

Benefits:

401(k) Dental insurance Health insurance Vision insurance

Experience:

healthcare collections, accounts receivable: 3 years (Required) managing a collections team: 1 year (Required)

Work Location:

Hybrid remote in Nashville, TN