Lead Biller

About the Role

The Lead Biller works collaboratively with clinical, front office, credentialing, coding, finance, and leadership teams to optimize revenue cycle performance while supporting the mission of providing high-quality healthcare services to underserved populations. This position oversees the daily operations of the billing department and actively participates in all aspects of medical billing and claims processing, serving as the primary resource for billing staff.

Responsibilities

• Serve as the day-to-day lead for the billing team by assigning work, monitoring productivity, and providing ongoing support.
• Train, mentor, and onboard new billing staff; assist with employee performance evaluations and provide coaching when needed.
• Monitor workloads to ensure billing deadlines are met and develop and maintain departmental billing procedures.
• Serve as the subject matter expert for billing policies and payer requirements; promote teamwork and continuous process improvement.
• Maintain active certification with an approved credentialing agency.
• Collect, process, and identify patient/payer payments, complaints, and concerns; make recommendations to management regarding policy, workflow, and staffing changes.
• Evaluate patients’ financial status and establish budget payment plans; follow and report the status of delinquent accounts.
• Perform various collection actions, including contacting patients, correcting and resubmitting claims to third-party payers.
• Participate in educational activities and attend monthly staff meetings; conduct annual training courses in accordance with NHA’s employee manual.
• Maintain strict confidentiality and adhere to all HIPAA guidelines/regulations; train medical staff and front desk to assure proper claim submission.
• Develop and participate in provider and staff training on coding best practices to ensure smooth and clean claim submission.
• Remain current with coding changes and provide recommendations for process flow changes according to best practices and billing standards.
• Research correct and new codes to ensure maximum revenue opportunity.
• Serve as the main point of contact with the outsourced billing company to increase revenue and eliminate duplicate coding errors.
• Provide staff with tools to ensure charts are documented according to billing standards and compliance requirements.
• Prepare quarterly audits for the organization in accordance with best practices for patient chart documentation.
• Review HEDIS measures with the quality team to support best practices for reimbursement and value-based care (VBC) submissions.

Requirements

• Must have a coding certification from an approved credentialing body.
• 3-5 years of experience in a physician or hospital billing environment.
• 2-4 years of coding experience.
• Advanced knowledge of medical billing/collection practices and business office procedures.
• Must be well-organized, detail-oriented, and able to keep staff engaged in daily activities.

About Us

Neighborhood Health Association (NHA) is Northwest Ohio’s largest community health center system. Since 1969, we’ve grown to 13+ clinics offering medical, dental, pediatric, women’s, senior, and homeless care—plus a full-service pharmacy and lab. We focus on prevention and helping people take charge of their health.

Our Mission: Through our exceptional health care services, we empower and educate, aggressively working to eliminate health care inequities, while supporting personal responsibility for one’s own health regardless of the ability to pay.