Medical Billing Lead

Prime Healthcare•Mesquite, TX

2d•Onsite

About The Position

We are seeking a Medical Billing Lead, sometimes referred to as Physician Office Billing Lead or Lead Medical Billing & Coding Specialist. The Medical Billing Lead oversees billing, coding, claims follow-up, and reimbursement activities to support accurate and timely revenue cycle operations. The Medical Billing Lead reviews documentation and coding, resolves claim issues, educates providers and staff on payer requirements, and assists with credentialing and process improvement. The Medical Billing Lead also supports and trains billing staff while monitoring daily operations, accounts receivable, and compliance with regulatory and payer guidelines.

Requirements

Knowledge of multiple insurance billing requirements and 3-5 years of billing experience
Knowledge of HIPAA confidentiality requirements, maintains strictest confidentiality.
Knowledge of Epic, Excel, Word, and clearinghouse software.
Knowledge of CPT, HCPCS, ICD-10 coding protocols, Medicaid, third party and Medicare billing and coding.
Knowledge of regulatory standards appropriate for position.
Ability to understand and apply applicable rules, regulations, policies and procedures.
Ability to communicate effectively.
Ability to establish and maintain effective working relationships with clinicians and patients.
Ability to multi-task, prioritize needs to meet required timelines
Analytical and problem-solving skills.
Customer Services experience required
High School Graduate or GED equivalent Required

Responsibilities

Review coding, documentation, and claims in Epic to ensure accurate and compliant billing before submission
Submit and follow up on insurance, workers’ compensation, HMO/PPO, and other third-party claims through final resolution
Train and support billing staff, clinicians, and providers on coding guidelines, payer policies, and billing processes
Monitor charge entry, claim submission, payment posting, denials, rejections, and monthly accounts receivable reporting
Assist with provider and facility credentialing, process development, compliance initiatives, and resolution of patient billing concerns