Billing Team Lead

The Billing Specialist, Team Lead serves as a resource to the billing team by providing peer-to-peer guidance and training while supporting the coordination of daily billing workflows. This role assists with issue resolution, answers process-related questions, and helps ensure billing activities are completed accurately and efficiently. The Team Lead also collaborates with facility partners and internal teams to support timely claim processing and plays an active role in month-end processes to help ensure a smooth close.

Responsibilities:

• Provide first-level support and guidance to a team of 12–15 billing team members, serving as a resource for billing-related questions and process clarification.
• Serve as a resource for functional training of new hires, offering ongoing guidance on daily responsibilities, workflow execution, and process clarification.
• Partner with the Process Documentation Team to ensure documentation updates are approved and updated in a timely manner.
• Partner with QA Team to ensure quality and productivity metrics are reported and consistently met.
• Responsible for maintaining training materials and assisting with training content development based on QA results and team member education opportunities.
• Provide coverage for team members who are out of the office to ensure continuity of daily billing operations and workflow.
• Monitor billing processes and identify opportunities to improve workflow efficiency, accuracy, and overall team productivity.
• Perform and support daily billing transactions to ensure accurate claim generation and clean claim transmission.
• Coordinate and support recurring billing workflows to ensure claims are generated and transmitted accurately and timely
• Support the charge entry and billing process for assigned cases and ensure claims are submitted to the designated electronic claims clearinghouse in a timely manner.
• Resolve claim rejections daily to ensure clean claims are transmitted and successfully received by the appropriate payer.
• Maintain current knowledge of healthcare billing laws, rules, regulations, and industry developments to ensure compliance with billing standards and payer requirements.

Required Skills

• Ability to read and interpret managed care contracts.
• Strong organizational and time management skills with the ability to prioritize competing tasks.
• Ability to communicate effectively, both verbally and in writing, with internal and external clients.
• Ability to work independently while managing multiple priorities.
• Intermediate computer proficiency in Microsoft Office including Excel and Outlook.

Required Experience

• Minimum of 2 years of Surgical Hospital, ASC revenue cycle, or orthopedic charge entry experience preferred.
• Experience working with a variety of healthcare insurance payers preferred.
• Experience with systems such as Cerner, Meditech, AdvantX, CPSI, FinThrive, Inovalon, Provision, or Waystar preferred.
• Demonstrated ability to mentor peers and support team development.
• High School Diploma or equivalent required.

Qualifications:

• Ability to read and interpret managed care contracts.
• Strong organizational and time management skills with the ability to prioritize competing tasks.
• Ability to communicate effectively, both verbally and in writing, with internal and external clients.
• Ability to work independently while managing multiple priorities.
• Intermediate computer proficiency in Microsoft Office including Excel and Outlook.