Mentor assigned billers, providing continuous feedback to promote improved productivity and effectiveness of their work efforts.
Serve as the first point of escalation for difficult or unresolved accounts.
Assist in assigning daily work to team members based on priority, complexity, and individual skill sets.
Ensure timely follow-up on rejected claims and adherence to payer guidelines while meeting established performance expectations.
Handle claims requiring advanced payer knowledge, contract review, and multi-step resolution processes.
Submit claims in accordance with Federal, State, and payer guidelines.
Research, analyze, and resolve claim errors and rejections, ensuring accurate corrections are made.
Minimize claim denials and returns due to controllable errors by ensuring correct submissions.
Stay current with payer updates and process changes for precise claim management.
Work with client departments on trends for rejections reduction and faster payments.
Communicate payer-specific issues to the team and management.
Lead and contribute to daily shift briefings.
Support onboarding new hires.
Perform additional assigned tasks as required.

High school diploma or equivalent required; Associate degree preferred
HFMA CRCR certification or completion of certification required within 90 days of hire.
Minimum 2 years of experience in billing initial claims for either hospital or physician (HCFA1500/UB04) and fixing rejections, holds within the clearinghouse and/or host systems
Prior mentoring experience.
Certified Professional Biller (CPD) billing certification preferred.
Experience using clearing houses systems such as Waystar, Quadex, SSi or similar platforms for billing.
Proficiency in Microsoft Office Suite, Teams, and various desktop applications.
Knowledge of coding guidelines for claim errors.
Understanding of Healthcare Revenue Cycle administration rules and regulations.
Knowledge of ICD-10 diagnosis and procedure codes as well as CPT/HCPCS codes.
Strong investigative skills to identify and resolve reasons for non-payment on medical accounts.
Proficiency in computers and Microsoft Office Suite/Teams, with experience using GoToMeeting/Zoom.
Ability to make informed decisions and take appropriate action.
Demonstrates a positive attitude and pleasant demeanor at work.
Willingness to learn, grow, and respond constructively to feedback for continuous improvement.
Professional interaction with colleagues and punctual, dependable work habits.
Ability to adapt easily to change and perform duties with ethical decision-making.
Demonstrates accountability, responsibility, and accomplishments in the revenue cycle process.

Billing Team Lead

Key skills