Position Summary:
As a growing organization, we are seeking a full-time Billing Specialist Lead to take a key leadership role in overseeing our end-to-end revenue cycle operations. This position is responsible for guiding the billing team, optimizing reimbursement processes, and driving successful outcomes in third-party and client collections. As a vital member of our clinical support leadership team, the Billing Specialist Lead will proactively manage payer relationships, ensure compliance, and implement best practices to support timely and accurate revenue capture.
Pay Range: $25-$30/hour
Essential Duties and Responsibilities:
- Timely, complete, and accurate initial submission of claims, follow-up, and re-submission of claims, as necessary
- Own and nurture payor relationships, manage follow-up on special projects, and resubmission of denied claims
- Monitor and report on the aging of accounts receivable and reason codes for claim denials
- Investigate claim denials timely, identify reasons for denials, and take appropriate actions to appeal or correct denied claims to ensure maximum reimbursement.
- Collaborate with the client intake department, the authorizations department, and other internal stakeholders on day-to-day billing functions and special projects
- Reconcile and distribute accurate and timely patient account statements
- Initiate collections activities for past due accounts and negotiate payment plans or arrangements
- Post collections to practice management software and process remittances from payors
- Recommend and implement process improvements in the areas of revenue cycle management, billing, payor relations, and compliance
- Maintain positive relationships with all current clients, prospective clients, clinical staff, prospective employees, fellow team members and referral sources
- Communicate effectively with families on benefits and insurance costs
- Ensure compliance with relevant healthcare regulations, coding guidelines, and insurance policies, and follow best practices for medical billing and coding
- Supervise day-to-day activities and assignments, monitor daily efficiency and productivity, and provide training, coaching, and technical support as indicated.
- Assist with the planning and implementation of quality assurance for all processes.
- Conduct routine staff meetings regarding authorization planning and implementations.
Essential Skills:
- Highly organized, structured thinker who is detail-oriented and thrives working in the weeds
- Unwavering focus on customer service, delivering exceptional experience to both clients and clinicians
- Resilience in pursuing projects until completion; able to push for outcomes respectfully and professionally
- Clear written and verbal communication and strong interpersonal skills; comfortable with cold-calling and demanding escalation from payors where necessary
- Ability to work independently with minimal supervision and lead with a solution-oriented mindset
- Strong computer and IT skills with the ability to independently set up office equipment at a home workstation (remote workers)
- Strong proficiency with Microsoft Office (Microsoft Word, Excel, PowerPoint, and Outlook)
- Advanced level in understanding medical terminology and mathematics
Minimum Qualifications (Knowledge, Skills, and Abilities):
- Bachelor’s degree
- Two to four years of experience in healthcare billing/collections, pre-authorizations, and payment posting
- Experience in speech, occupational, and physical therapy is preferred but not required
- Experience using Raintree EMR preferred, but not required
Location and Schedule:
- Remote, Monday-Friday 8:00 am - 5:00 pm, 40 hours/week
Physical Requirements:
- Sitting at a desk for prolonged periods
- Typing and mouse usage
- Use of office equipment