Collections Lead - Provider Escalation

Benefits

• Comprehensive Health Coverage – Medical, dental, and vision plans to keep you and your family healthy.
• Future Security: 401(k) with matching
• Student Loan Support – Up to $10,000 repayment assistance, because we invest in your future.
• Educational Tuition Assistance
• Competitive Pay & Full Benefits – A salary and package designed to reward your expertise and dedication.

Job Summary

The Collections Lead is responsible for managing complex provider escalation accounts and driving resolution efforts through the final stages of the claims and appeals process. This position works closely with healthcare provider representatives to support successful claim overturns and timely account resolution.

This role is process-focused and serves as a lead within the provider escalation workflow by ensuring accounts are handled efficiently, escalations are resolved appropriately, and final collection recovery opportunities are maximized. While this is not a direct people-management or training position, it requires strong leadership in process execution, accountability, and operational support.

Essential Functions

• Monitors and analyzes collection activities and key performance metrics, making adjustments to strategies as needed to meet department goals.
• Resolves complex or escalated collection cases, negotiating payment arrangements and collaborating with internal departments to address disputes.
• Develops and implements process improvements and strategies to enhance collection efficiency and reduce outstanding receivables.
• Maintains accurate and detailed records of collection efforts and prepares regular performance reports for management.
• Collaborates with cross-functional teams to address account discrepancies and optimize processes.
• Performs other duties as assigned.
• Maintains regular and reliable attendance.
• Complies with all policies and standards.

Qualifications

• H.S. Diploma or GED required
• Associate Degree or higher preferred
• 5-7 years of collections experience in a medical facility, ambulatory surgery facility, or acute-care hospital required

Knowledge, Skills and Abilities

• Excellent communication and negotiation abilities.
• Analytical and problem-solving skills.
• Proficiency in collection software, Google Suite, and Microsoft Office, especially Excel.
• Knowledge of CPT, HCPCS, ICD-9, and debt collection laws and regulations.

The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency.

Community Health Systems is one of the nation’s leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

Originally posted on Himalayas