Job Description

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