PHYSICIAN BILLING TEAM LEAD

Essential Duties

• Team Leadership & Training: Lead, train, and mentor the AR team, ensuring all members are equipped with the necessary skills and knowledge to perform their duties effectively.
• Billing & Collections: Oversee all billing and collection activities related to insurance accounts receivable, ensuring accuracy and compliance with established procedures.
• Claims Management: Handle complex insurance denials, perform root cause analysis, and implement corrective actions to reduce and prevent future denials. Engage in appeals processes to secure payment resolution.
• Process Improvement: Identify and recommend opportunities for improving customer service, system processes, and overall efficiency. Partner with management to implement necessary changes.
• Compliance & Standards: Ensure adherence to HIPAA privacy standards and compliance with patient health information privacy practices in all communications. Maintain an understanding of evolving payer classifications and reimbursement policies.
• Coding & Documentation: Review and resolve coding-related denials, correcting CPT, ICD-10, and HCPCS codes as needed. Maintain coding compliance and stay updated with recognized coding guidelines and billing requirements.
• Collaboration: Actively participate in payer calls, provide feedback to payer representatives, and escalate issues as necessary. Keep the manager informed of progress, achievements, and any issues that arise.
• Productivity & Quality: Run staff productivity, perform monthly audits, and provide feedback to staff.
• Special Projects: Assist with special projects and other duties as assigned, as necessary.

Non-Essential Duties

• Assist with other administrative duties or tasks as assigned by management.
• Support cross-functional teams as needed for comprehensive billing and collection processes.

Responsibilities

• Completion of ICD-10 and CPT coding courses from AAPC or AHIMA is required.
• 2-3 years of experience in collections, claims follow-up, or denials required.
• Experience in a physicians office or other healthcare setting preferred.
• Knowledge of insurance and authorization processes is helpful.
• Previous experience with EPIC is preferred.
• Understanding of the hospital or physician revenue cycle is preferred.

Required Licensure/Education

• A High School Diploma or equivalent required.
• A Certified Coder required or must obtain within 6 months of hire.

Preferred Education

• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Proficiency in maintaining confidentiality and adhering to privacy regulations.

Pay Range

USD $24.12 - USD $29.50 /Hr