Lead Billing Specialist, Tier I

FAMILY HEALTH CARE CENTER OF KALAMAZOO • Kalamazoo, MI

8d

About The Position

The Lead Billing Specialist Tier I oversees daily billing operations and ensures billing processes are accurate, efficient, and compliant with company policies. The role resolves complex claims, denials, appeals, and unpaid balances; investigates billing questions from staff, patients, and payers; and provides customer support. It also prepares and reviews performance reports to identify improvement opportunities and serves as a resource to billers and other departments by providing guidance, training, and support for workflow improvements.

Requirements

• Minimum of a high school diploma.
• Experience with payer appeals processes.
• Knowledge of FQHC policies and requirements.
• Exceptional customer service skills.
• Strong analytical skills.
• Knowledge of FQHC or RHC billing rules and regulations.
• Ability to use a PC and other office equipment.
• Ability to occasionally lift and/or move up to 25 pounds.

Nice To Haves

• CPC or CPB certification.
• An associate degree in Business with an emphasis in Accounting or Finance from an accredited college or university, in addition to two years of experience, or an equivalent combination of education and experience.
• Knowledge of the EPIC system and relevant third-party liability (TPL) and government websites, such as CHAMPS, C-SNAP, Connex, Medicare DDE, Availity, and HMO Medicaid sites used by FHC.
• Working knowledge of ICD-10, HCPCS, and CPT.

Responsibilities

• Oversee daily billing activities and ensure processes are efficient, accurate, and consistent with company policies.
• Resolve complex claims, denials, appeals, and unpaid balances.
• Investigate and resolve billing questions and problems for staff, patients, and payers.
• Prepare and review reports and audits to monitor billing performance and identify areas for improvement.
• Support and communicate with patients and staff regarding billing inquiries.
• Provide guidance and training to billers and other departments on billing processes and workflow improvements.
• Promote safety precautions and security measures for staff and patients.
• Follow data security guidelines, including appropriate use of EMR systems and IT resources.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED