Lead Medical Biller

Lead Medical Biller

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

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.

Qualifications:

• Good verbal and written communication
• 2+ years of Lead Medical Biller experience required
• Medical billing diploma or work experience Lytec or Medisoft experience a plus
• Certification as a Certified Professional Coder (CPC) preferred
• Knowledge of Microsoft Office, especially Excel
• High School diploma or equivalent is required.

Pay:

• $25-27/hr Depending on experience

Benefits:

• Health, Dental, Vision Insurance
• Generous 401 K plan
• Paid time off
• Life Insurance

Great Place to Work® Certified!

Skilled Wound Care is proud to be Certified™ by Great Place to Work® for the 3rd year in a row. The prestigious award is based entirely on what current employees say about their experience working at Skilled Wound Care. This year, 95% of employees said it's a great place to work – 39% higher than the average U.S. company.