Lead Medical Biller

Job Description

Job Description

Lead Medical Biller

Los Angeles, CA

Job Description

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) preffered

• 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.

Skilled Wound Care will ask all candidates to perform pre-employment confidential DiSC testing and appropriate relevant skills testing prior to hiring.

Skilled Wound Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age (40 or older), disability or genetic information. Compensation is DOE.