Lead Billing Specialist

Job Description

Job Description

POSITION: Lead Billing Specialist

FLSA Status: Full-Time, Exempt

REPORTS TO: Lead, or Accounts Receivable (A/R) Manager

Position Overview:

Responsible for the accurate and timely preparation, processing, reporting and monitoring of invoices and billing transactions supporting financial integrity and ensuring charges are correct, payments are applied appropriately and discrepancies are resolved promptly, in accordance with all company policies, core values, and local, state and federal laws governing the business. The Lead will provide additional operational support as a mentor, providing leadership, guidance, support, training, task oversight and other supervisory responsibilities for department and/or affiliated location employees as assigned.

Essential Functions:

• Must be at work on time/when expected, representing the company in a positive and professional manner, leading by example in dress, composure and behavior

• Prepares, reviews and disperses invoices, verifying accuracy and authorization(s) in accordance with their contractual terms and company processes and procedures

• Supports the finance and accounting department members by maintaining accurate records, identifying discrepancies, and ensuring data integrity

• Monitors billing queue(s) to ensure timely submission of invoices resolving any

  discrepancies, rejected invoices and responding to related inquiries as needed

• Posts payments, adjustments, and credits reconciling billing records to general ledger and any related subledger(s)

• Collaborates and coordinates with other departments and/or billing and/or payor sources to validate and reconcile billable services or charges

• Assists with month-end closing activities as assigned

• Generates and distributes billing and aging reports as directed

• Supports internal and external audits as requested – escalating complex claims/issues

• Safeguards company property and confidentiality at all times, maintaining internal controls and procedures to prevent fraud and errors in the billing processes

• Assists with hiring, onboarding, training and performance management of new Billing Specialists (or other department team members), first point of contact for questions

• Acts as “buddy” allowing new employees to job shadow making sure they feel welcomed and supported and understand all job expectations and requirements

• Provides real-time coaching, correction, feedback and guidance to staff members

• Acts as liaison for complex, rejected, difficult or escalated billing issues completing root cause analysis and ensuring accurate follow up documentation to all involved parties.

• Continually analyzes documentation and processes making recommendations to improve policies, and/or workflows to ensure continued improvements in operational efficiencies

• Researches and oversees corrections of any billing errors to ensure accurate submissions of claims to insurances companies and third-party payers

• Reviews work assignments for balance/fairness and that duties are completed timely

• De-escalates problems/conflicts/concerns, models and encourages respectful communication

• Knows when to, and appropriately escalates concerns to senior management

• Analyzes aging reports, identifying trends and developing solutions to reduce “days in accounts receivable”

• Collaborates with clinical staff, coders and other cross functional team members to ensure accurate recordkeeping and billing

• Leads departmental preparation for internal/external audits and month-end closing activities

• Maintains expert-level knowledge of payer guidelines, billing regulations, and

  compliance standards (e.g., HIPAA) ensuring team members are trained/updated as necessary

• Prepares and delivers various reports and metrics as related to the position,

  department and on the performance of all collection related personnel

• Completes special projects and other duties as assigned and relevant to the department

• Other duties as assigned and related to the department

Essential Soft Skills:

• Treats everyone fairly with kindness, dignity and respect in accordance with the

Company

• Communicates in a professional manner with everyone associated with the business

• Demonstrated ability to actively listen and respond kindly even when others express negative emotions (frustration, anger, etc.)

• Leads by example, expressing positivity and exhibits ethical behavior, demonstrating the desire to work harmoniously with others

• Uses good judgement – escalating complex, sensitive matters and making independent decisions when necessary

• Consistent attendance and punctuality

• Outstanding customer service and communication skills

• Positive attitude and professional behavior – in all situations

• Willingness to mentor and support others

• Completed company supervisor training and exemplifies company Core Values

• Demonstrated ability to work collaboratively with everyone at work

• Compliance with all policies, procedures and regulations governing the industry

• Extremely detail oriented and highly organized

• Skilled in time management and meeting deadlines

• Ability to read, write and understand the English language

• Outstanding oral/verbal, and written communication skills

• Works well with all levels of personnel within the company

Essential Qualifications:

• High school diploma or equivalent; Associate’s degree or certification in medical

  billing/coding preferred

• 4+ years experience in billing, accounts receivable or related finance function required

• Proficiency in billing software and electronic health record (EHR) systems.

• Strong knowledge of medical terminology, coding systems (ICD-10, CPT), and insurance processes.

• Proven success working under deadlines

• Proven data accuracy and attention to detail required

• Ability to analyze financial data, spreadsheets, invoices, etc. identifying discrepancies

• Technology proficiency / strong computer skills (Microsoft Office, internet, apps, etc.)

• Multi-entity experience within healthcare or hospitality sector preferred

• Ability to work independently while supporting internal and external customers

• Proven interpersonal skills with the ability to communicate kindly, effectively and professionally, both orally and in writing, across all levels of the organization

• Proficiency with financial or billing systems

• Ability to travel across California – current driver’s license and personal car and/or ability to utilize public transportation options to meet business needs

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the position.

• Remote setting with some travel.

• Primarily sedentary office work with ability to stand, sit, walk throughout the workday

• Use of various technology/computers (typing, screens), sitting at a desk for long periods

• Bend, reach, stoop, kneel, crouch, reach, push and pull up to 25 lbs

• Ability to climb, crawl and balance as needed for setting up office / work area(s)

• Use of fingers/hands to type, handle, pick up and feel objects, using tools as needed

• Must see and hear with, or without, prosthetics that enable these sense to function adequately to ensure all requirements for the position are met

• Possible exposure to communicable diseases, infections, blood-borne pathogens, drugs, chemicals and other biological or infections hazards (client communities/facilities)

• Ability to travel via plane, car, or use public transportation as needed for work

• May work on-call, occasional weekends, evening or night work as needed to cover the needs of a 24/7 business

• Ability to cope with the mental and/or emotional stress of the position