Funded Collections Manager

Candidates must reside within the Eastern or Central Time Zone. This is a remote position that requires occasional travel to our Pittsburgh corporate office as needed.

Work Schedule: Monday-Friday, 8:00 AM-5:00 PM EST

What you'll do:

The Manager, Funded Collections leads the operational performance, people, controls, and continuous improvement of funded insurance collections. The role is accountable for timely and accurate account follow-up, adjustment and write-off governance, denial and appeal resolution, documentation quality, cash acceleration, aging reduction, and compliance across Medicare, Medicaid, commercial payer, and patient receivables. The Manager partners across Funding, Billing, Finance, Accounting, Customer Service, Compliance, Sales, and Technology to resolve barriers throughout the order-to-cash lifecycle. The role is also designed to build the operational breadth, financial understanding, people leadership, and cross-functional partnership needed for potential progression to Senior Manager, based on sustained performance, demonstrated readiness, organizational need, and company promotion practices.

As a Manager, Funded Billing & Collections, you will be responsible for:

1. Funded Collections Leadership

• Lead daily and monthly Funded Collections operations, establish priorities, balance workloads, and ensure timely execution against cash, aging, denial, appeal, productivity, and quality objectives.
• Create clear performance expectations, operating routines, escalation pathways, and accountability across collectors and team leads.
• Monitor portfolio risk and trends, identify barriers to collectability, and implement corrective action plans.
• Ensure funded insurance balances are worked consistently and supported by complete account documentation and appropriate follow-up.
• Provide leadership visibility into performance, risk, resource needs, and improvement opportunities.

2. Adjustment and Write-Off Governance

• Own and maintain a standardized process for preparing, submitting, reviewing, documenting, approving, and entering contractual, small-balance, and bad-debt adjustments.
• Ensure account reviews validate the patient and chart number, date of service, equipment or HCPCS code, payer, adjustment reason, requested amount, balance location, and supporting documentation.
• Ensure OMI, AMD notes, EOBs or remits, authorizations, payer correspondence, claim history, and other relevant documentation are reviewed and retained as required.
• Oversee management review and accurate entry of approved insurance write-offs in AdvancedMD, including the appropriate source, date of service, code, and amount.
• Maintain approval controls and route requests according to established authority thresholds.
• Ensure rejected requests are returned with clear feedback and corrected within established turnaround expectations.
• Identify repeated payer, network-status, timely-filing, billing-method, primary or secondary coverage, and unapplied-cash issues and escalate systemic concern

3. Denial, Appeal, and Receivable Performance

• Lead strategies to resolve denials, underpayments, authorization issues, timely-filing concerns, coordination-of-benefits issues, and other payer barriers.
• Ensure appeals and payer follow-up are timely, well documented, supported, and aligned with payer requirements.
• Use account-level and trend analysis to reduce preventable denials, rework, and write-offs.
• Partner with Accounting and Finance on collectability, reserves, reconciliations, period-end reporting, and audit support.
• Create actionable reporting that connects collection activity to cash, aging, risk, and financial impact.

4. Process, Quality, Compliance, and Controls

• Create, maintain, and govern policies, procedures, work instructions, templates, quality checks, and documentation standards.

• Ensure requests use the correct adjustment path, one adjustment reason, and one date of service per form when a form is required.

• Confirm supporting documents are attached, uploaded to the account, and filed in the appropriate shared location as required.

• Conduct quality reviews and use findings to provide coaching, correct systemic issues, and strengthen first-time-right performance.

• Ensure compliance with company policies, payer contracts, privacy and security requirements, and applicable laws and regulations.

• Maintain audit-ready documentation and effective operational controls.

5. Operational Excellence and Technology

• Lead continuous improvement initiatives that simplify work, reduce manual effort, eliminate unnecessary handoffs, and improve data quality.
• Partner with Technology and business stakeholders on AdvancedMD, OMI, reporting, workflow, automation, and system enhancements.
• Use data to identify root causes, prioritize improvements, quantify impact, and confirm sustained results.
• Build scalable processes and business-continuity coverage that support growth and changing workload demands.
• Develop business cases and recommendations for workflow, technology, staffing, and capability investments.

6. Cross-Functional and People Leadership

• Build productive partnerships across Revenue Cycle Operations and other functions to resolve upstream issues affecting billing and collectability.
• Lead cross-functional reviews, clarify ownership, and create shared accountability for documentation, authorization, enrollment, billing, and payer issues.
• Recruit, onboard, coach, develop, and retain a high-performing team with clear goals and regular feedback.
• Develop team leads and emerging leaders through delegation, stretch assignments, succession planning, and role-based learning.
• Foster a collaborative, accountable, customer-focused culture that supports continuous learning and improvement.

What you'll bring:

Core Performance Outcomes

• Improved cash realization and predictability.
• Reduced aged receivables, avoidable denials, rework, and preventable write-offs.
• Accurate, complete, timely, and consistently approved adjustments and write-offs.
• Strong documentation quality, compliance, and audit readiness.
• Clear leadership reporting and timely escalation of material risks.
• Scalable workflows and technology-enabled improvements.
• A capable, engaged team with effective team-lead and succession coverage.

Director Development Path

The Manager is expected to expand from strong functional ownership toward broader enterprise leadership. Development should be demonstrated through progressively larger scope, sustained business results, leadership through others, and effective influence beyond Funded Collections.

Director-Readiness Focus Areas

• Enterprise strategy: Connect Funded Collections priorities to broader revenue cycle, customer, operational, and financial objectives.
• Financial leadership: Build fluency in cash forecasting, reserves, collectability, write-off exposure, investment decisions, and financial tradeoffs.
• Organizational leadership: Build an effective leadership structure, strengthen succession coverage, and deliver results through managers and team leads.
• Cross-functional influence: Lead complex initiatives requiring alignment across multiple functions and senior stakeholders.
• Executive communication: Present concise, decision-oriented updates that explain performance, risk, options, impact, and recommended action.
• Technology and scalability: Sponsor material automation, workflow, reporting, or system improvements with measurable business value.
• Change and risk leadership: Anticipate emerging payer and operational risks, lead mitigation plans, and sustain adoption of new controls and processes.

Example Development Assignments

• Own or co-lead the annual Funded Collections operating plan and performance review.
• Lead an enterprise cash-acceleration, denial-prevention, write-off-reduction, or order-to-cash initiative.
• Develop and present a business case for a significant technology, workflow, reporting, or staffing investment.
• Present portfolio performance, risks, and recommendations to senior leadership.
• Build a succession and capability plan for the Funded Collections leadership structure.
• Represent Funded Collections in governance, audit, compliance, or technology workstreams.
• Process improvement: Lead measurable improvements in workflow, documentation, quality, reporting, and system use.
• Leadership communication: Provide clear updates on performance, risk, barriers, corrective actions, and support needed.
• Cross-functional partnership: Lead issue resolution with Funding, Billing, Finance, Accounting, Customer Service, Compliance, Sales, and Technology.
• Leadership through others: Strengthen team-lead capability, delegate effectively, and build dependable coverage and succession.
• Financial understanding: Build fluency in cash, aging, collectability, write-off exposure, productivity, and financial impact.
• Functional ownership: Take accountability for Funded Collections performance, controls, priorities, and follow-through.

Senior Manager-Readiness Focus Areas

The Manager is expected to grow from strong day-to-day team leadership toward broader functional ownership. Development should be demonstrated through sustained operational results, effective coaching and delegation, sound decision-making, and cross-functional partnership.

Education and Experience

• Bachelor's degree in Business, Finance, Accounting, Healthcare Administration, or a related field, or an equivalent combination of education and relevant experience.
• Minimum of four years of progressive healthcare revenue cycle, medical collections, or accounts receivable experience, including at least two years in people leadership or team-lead responsibility.
• Experience in complex Medicare, Medicaid, commercial insurance, patient receivable, denial, appeal, and reimbursement environments.
• Experience leading measurable improvement in collections performance, documentation quality, controls, and team capability.
• Experience with durable medical equipment billing, prior authorization, payer funding requirements, contractual adjustments, and write-offs preferred.

Knowledge and Skills

• Strong understanding of healthcare collections, payer follow-up, denials, appeals, coordination of benefits, timely filing, contractual adjustments, and bad debt.
• Ability to interpret operational and financial data, identify trends and root causes, assess risk, and convert findings into action.
• Experience with healthcare billing, collections, workflow, document-management, and reporting systems; AdvancedMD and OMI experience preferred.
• Advanced proficiency in Microsoft Excel, Word, PowerPoint, Outlook, Teams, and related collaboration tools.
• Strong written, verbal, presentation, coaching, and stakeholder-management skills.

Leadership Competencies

• Strategic and Business Oriented: Connects functional priorities to company objectives and measurable financial and customer outcomes.
• Ownership and Execution: Establishes a clear path forward, removes barriers, and follows through on commitments.
• Analytical and Structured: Uses evidence, sound controls, and disciplined routines to improve decisions and results.
• People Leadership: Develops leaders and teams, delegates effectively, and reinforces accountability and learning.
• Change Leadership: Builds commitment, manages risk, and sustains improved ways of working.
• Communication and Influence: Communicates clearly across levels and functions and builds alignment around shared goals.
• Integrity and Collaboration: Acts ethically, welcomes constructive challenge, and builds trust across the organization.

Work Environment

• Ability to work effectively in a fast-paced environment with interruptions and competing priorities.
• Ability to collaborate across functions, locations, and levels of the organization.
• Ability to see, hear, communicate effectively, sit for prolonged periods, and occasionally lift up to 10 pounds.
• Ability to travel to Corporate office per business requirements.

Acknowledgement

This job description summarizes the primary responsibilities and qualifications of the position. Responsibilities may evolve based on business needs, and other duties may be assigned. Career progression is not automatic and depends on sustained performance, demonstrated readiness, organizational need, and company practices.

Apply today!

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