We are seeking an experienced Claims Resolution Manager to oversee our Accounts Receivable (A/R) Follow-Up team, ensuring timely and accurate resolution of outstanding insurance claims. This role focuses on reducing aging A/R, improving reimbursement rates, and driving team performance through effective leadership, process optimization, and payer relationship management..
Key Responsibilities
- Lead and manage the daily operations of the A/R Follow-Up team, including workload distribution, productivity monitoring, and performance management.
- Analyze aging reports and identify trends, bottlenecks, and root causes of claim delays or denials.
- Develop and implement strategies to reduce A/R days and maximize cash collections.
- Oversee resolution of complex or escalated claims, including payer disputes and appeals.
- Ensure compliance with payer guidelines, regulatory requirements, and company policies.
- Collaborate with billing, coding, credentialing, and client services teams to resolve upstream issues impacting claims.
- Track and report key performance indicators (KPIs) such as resolution rates, denial rates, and collector productivity.
- Provide coaching, training, and ongoing development for team members to improve efficiency and quality.
- Maintain strong working relationships with insurance payers and clearinghouses.
- Support process improvement initiatives and implementation of RCM tools or systems.
Qualifications
- Bachelor’s degree in Healthcare Administration, Business, or related field (or equivalent experience).
- 3–5 years of experience in Revenue Cycle Management, with at least 1–2 years in a supervisory or team lead role.
- Strong knowledge of insurance claims processing, denial management, and A/R follow-up practices.
- Experience working with major payers (Medicare, Medicaid, and commercial insurance).
- Proficiency in RCM systems, EHR platforms, and reporting tools.
- Strong analytical, problem-solving, and organizational skills.
- Excellent communication and team leadership abilities.
We are seeking a leader who excels in a fast-paced, metrics-driven environment, demonstrates accountability, and empowers their team to meet and exceed goals.
Job Type: Full-time
Pay: $55,000.00 - $65,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Education:
Experience:
- Revenue cycle management: 3 years (Required)
- Supervising: 2 years (Required)
Location:
- Lubbock, TX 79423 (Required)
Work Location: In person
