Billing Team Lead

Responsibilities

• Provide first-level support and guidance to a team of 12–15 billing team members, serving as a resource for billing-related questions and process clarification.
• 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.
• Provide coverage for team members who are out of the office to ensure continuity of daily billing operations and workflow.
• Maintain training materials and assist with training content development based on QA results and team member education opportunities.
• Monitor billing processes and identify opportunities to improve workflow efficiency, accuracy, and overall team productivity.
• Perform and support daily billing transactions to ensure accurate claim generation and clean claim transmission.
• Cover recurring billing workflows to ensure claims are generated and transmitted accurately and timely.
• Support the charge entry and billing process for assigned cases and ensure claims are submitted to the designated electronic claims clearinghouse in a timely manner.
• Resolve claim rejections daily to ensure clean claims are transmitted and successfully received by the appropriate payer.
• Maintain current knowledge of healthcare billing laws, rules, regulations, and industry developments to ensure compliance with billing standards and payer requirements.

Requirements

• Ability to read and interpret managed care contracts.
• Strong organizational and time management skills with the ability to prioritize competing tasks.
• Ability to communicate effectively, both verbally and in writing, with internal and external clients.
• Ability to work independently while managing multiple priorities.
• Intermediate computer proficiency in Microsoft Office including Excel and Outlook.
• Minimum of 2 years of Surgical Hospital, ASC revenue cycle, or orthopedic charge entry experience preferred.
• Experience working with a variety of healthcare insurance payers preferred.
• Experience with systems such as Cerner, Meditech, AdvantX, CPSI, FinThrive, Inovalon, Provision, or Waystar preferred.
• Demonstrated ability to mentor peers and support team development.
• High School Diploma or equivalent required.