Medical Billing Lead – Urology

We are seeking an experienced Medical Billing Lead with strong Urology billing experience to join our team as we transition from outsourced billing to an in-house billing department. This position will play a key role in learning our systems, establishing workflows, and training future billing staff.

The ideal candidate is highly organized, proactive, and capable of managing multiple priorities in a fast-paced environment. This individual must have strong knowledge of urology coding and billing practices, clearinghouse operations, Medicare guidelines, and insurance regulations, and must be able to lead the billing process with limited supervision.

This position will serve as the primary billing resource during the transition period and will help build a strong internal billing process to support the practice.

Key ResponsibilitiesBilling Operations

• Review medical documentation and reports to ensure accurate and timely billing
• Assign appropriate CPT, ICD-10, and HCPCS codes for procedures and surgeries
• Submit claims to insurance carriers and monitor claim status
• Review amounts posted in the system and ensure accurate billing submission
• Work and resolve claim denials, rejections, and underpayments
• Ensure maximum reimbursement for services rendered
• Audit billing reports to ensure accuracy and compliance

Accounts Receivable & Claims Management

• Research and resolve payment discrepancies
• Follow up with insurance carriers regarding unpaid or denied claims
• Maintain documentation and correspondence necessary to secure payment
• Review patient accounts and statements for accuracy and completeness

Leadership & Transition Support

• Assist with transition from outsourced billing to in-house billing
• Learn and optimize practice management and EMR systems
• Help develop billing workflows, processes, and internal procedures
• Train and support future billing team members
• Lead billing functions with limited supervision
• Identify opportunities for improved efficiency and revenue cycle performance

Compliance & Accuracy

• Ensure adherence to Medicare guidelines and insurance regulations
• Maintain knowledge of CMS, NCCI edits, payer policies, and billing updates
• Follow HIPAA privacy and security standards
• Ensure compliance with HMO, PPO, Medicare, and Medi-Cal guidelines

QualificationsRequired

• Several years of Urology medical billing experience
• Strong understanding of clearinghouse processes
• Knowledge of insurance billing guidelines
• Ability to manage high-volume billing workloads
• Strong organizational and multitasking skills
• Excellent verbal and written communication skills
• Strong problem-solving and analytical abilities
• Ability to work independently with minimal supervision

Preferred

• Experience with EMR / Practice Management Systems
• Knowledge of:
• ICD-10
• CPT
• HCPCS
• CMS guidelines
• NCCI edits
• Prior lead, supervisory or management billing experience
• Experience assisting with billing department setup or transitions

Job Type: Full-time

Pay: $21.00 - $26.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Education:

• High school or equivalent (Preferred)

Experience:

• ICD-10: 2 years (Required)
• Medical (Urology) Billing: 2 years (Required)

Work Location: In person