Lead Medical Biller

Skilled Wound Care•Los Angeles, CA

4h•$25 - $28•Hybrid

About The Position

Skilled Wound Care is looking for a Lead Medical Biller to join our rapidly growing company! We are a mobile surgical physician wound care group expanding into new markets of the United States. The Lead Medical Biller is a critical leader responsible for ensuring the financial health of our organization by overseeing the daily operations of the billing team. This role requires advanced expertise in the end-to-end claims lifecycle, ensuring maximum revenue capture through accurate, compliant, and timely submission of medical claims across all payer types (private, government, and third-party). You will be the primary subject matter expert, driving team performance, resolving complex billing issues, and upholding strict adherence to all federal, state, and FQHC-specific billing regulations. Position is hybrid at our office in Playa Vista, CA

Requirements

Good verbal and written communication
2+ years of Lead Medical Biller experience required
Medical billing diploma or work experience
Knowledge of Microsoft Office, especially Excel
High School diploma or equivalent is required.

Nice To Haves

Lytec or Medisoft experience a plus
Certification as a Certified Professional Coder (CPC) preffered

Responsibilities

Supervise & Train: Lead the training and mentorship of new billing hires, ensuring rapid integration and consistent adherence to best practices.
Quality Assurance: Assist management by conducting routine audits to ensure compliance with all regulatory and internal billing standards.
Workflow Management: Partner with management to efficiently re-distribute workloads, optimize team capacity, and maintain productivity.
Issue Resolution: Proactively identify, report, and collaborate on solutions for problematic issues impacting team duties, efficiency, or compliance.
Claim Submission: Review, prepare, and verify all claims for accuracy, completeness, and documentation, ensuring they meet specific payer requirements for "clean" submission.
Documentation & Verification: Verify all billing information, charges, patient documentation, and insurance coverage prior to claim submission.
Follow-Up & Denial Management: Perform timely and aggressive follow-up on outstanding claims, meticulously resolve denials by correcting errors, gathering necessary documentation, and resubmitting claims efficiently.
Payment Reconciliation: Analyze and interpret all Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs), confirm accurate payment posting, and manage all necessary claim appeals for underpaid or denied services.
Billing Compliance: Apply comprehensive working knowledge of governmental billing regulations, including Medicaid, Medicare, and Medi-Cal Managed Care.