Collections Specialist, Team Lead (Collections + Training)

Position Overview: Reporting to the Hospital Collections Supervisor, the AR Team Lead supports the Accounts Receivable team by performing advanced insurance collections activities while providing peerto-peer guidance and training to new hires. This role combines Level II and Level III AR responsibilities, including resolution of complex and high-dollar claims, contract review, denial management, and escalation support. The AR Team Lead serves as a subject matter resource for the team, assisting with onboarding, workflow prioritization, and best practices to ensure timely claim resolution and accurate reimbursement across all payer types. Responsibilities: Perform timely follow-up and resolution on outstanding A/R including unpaid, underpaid, or denied claims for all payer types including commercial, Medicare, Medicaid, and self-pay to maximize reimbursement. Serve as a resource for functional training of new hires, offering ongoing guidance on daily responsibilities, workflow execution, and process clarification. Partner with the Process Documentation Team to ensure documentation updates are approved and updated in a timely manner. Partner with QA Team to ensure quality and productivity metrics are reported and consistently met. Responsible for maintaining training materials and assisting with training content development based on QA results and team member education opportunities. Manage and prioritize daily work queues with a focus on high-dollar and complex claim balances. Investigate claim denials and underpayments, initiate appeals, and escalate issues when appropriate. Review payer contracts, fee schedules, and explanation of benefits (EOBs) to ensure claims have been processed accurately. Prepare and submit medical necessity appeals and supporting documentation when applicable. Review medical records and clinical documentation to determine medical necessity and support appeal submissions. Identify payer trends or reimbursement issues and communicate findings to leadership. Facilitate communication with insurance carriers, patients, and internal departments including billing, coding, and payment posting to resolve outstanding balances. Recommend account adjustments or refunds when overpayments or discrepancies are identified. Provide peer-to-peer onboarding support and mentorship for new AR collectors. Assist new hires in learning workflows, payer follow-up processes, and system navigation. Share best practices for denial resolution, appeal preparation, and claim follow-up. Serve as a subject matter resource for team members regarding payer policies, AR workflows, and claim resolution strategies. Assist leadership in addressing complex claim issues and identifying workflow improvement opportunities. Apply To This Job