Team Lead- Medical Billing

About the role

The Team Lead in Medical Billing is a leadership position responsible for overseeing and managing a team of medical billers and coders within a healthcare organization. The primary objective of this role is to ensure the accurate and timely submission of medical claims, while adhering to industry regulations and organizational standards. The Team Lead plays a vital role in maintaining the efficiency and effectiveness of the billing process, ensuring compliance with relevant laws, and optimizing the overall revenue cycle management

Responsibilities & Tasks

• Team Management and Supervision: Lead, mentor, and provide direction to a team of medical billing professionals. This includes conducting regular training, performance evaluations, and offering continuous support to team members to foster skill development and team cohesion.
• Billing Oversight: Ensure that all medical claims are accurately prepared, reviewed, and submitted to insurance companies and payers in accordance with established guidelines and industry standards
• Issue Resolution: Act as the primary point of contact for resolving billing discrepancies, claim denials, rejections, and appeals. Collaborate with insurance companies, patients, and healthcare providers to facilitate timely resolutions.
• Regulatory Compliance: Ensure the team's adherence to all relevant healthcare regulations, including HIPAA, CMS guidelines, and payer-specific requirements, to maintain the integrity and compliance of the billing process.
• Process Improvement: Continuously assess and refine billing procedures to improve efficiency, accuracy, and productivity. Implement best practices to enhance the team’s performance and minimize errors or delays in claims processing.
• Reporting and Analysis: Monitor and report on the performance of the team, tracking key metrics such as claim submission accuracy, revenue cycle status, and denial rates. Provide comprehensive reports to management for strategic decision-making.
• Collaboration: Work closely with other departments, including healthcare providers, insurance companies, and patient services, to ensure smooth communication and coordination in the billing process.
• Customer Service: Address billing inquiries from patients and third-party payers, providing clear and accurate information regarding billing procedures, payments, and account status.

Position Requirements

• Education: Bachelor's degree in healthcare administration, business, or a related field (preferred).
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification, HIPAA certification.
• Strong knowledge of medical billing and coding procedures, including ICD-10, CPT, and HCPCS codes.
• Experience: 4-6 years of experience as medical biller.

Required Skills

• Leadership
• Time Management
• Revenue Forecasting
• Monitoring and Supervision
• Staff Training & Development
• Problem Solving
• Auditing Proficiency
• Expertise in Medical Billing
• Reporting
• Proficiency in healthcare billing and coding software and EHR systems.

Goals / KPIs

KPI 1: First Pass Resolution Rate

KPI 2: Claim Lag Time

KPI 3: Coder Productivity

KPI 4: Clean Claim Rate

KPI 5: Denial Rate

KPI 6: Days in Accounts Receivable (A/R)

KPI 7: Net Collection Rate.

KPI 8: Cost to Collect.

KPI 9: Patient Satisfaction Score related to billing.

KPI 10: Timeliness of response to patient queries.

KPI 11: Resolution rate of patient billing concerns.

About 7 Kings Code

7 Kings Code has a global presence with our head office in Coral Springs, Florida.

We are US based IT Staffing & Software solutions company. We provide excellent customized IT Solutions to fit start-up to enterprise level companies. We support our partners and clients globally in USA, CANADA, EUROPE, INDIA, PAKISTAN & MIDDLE EAST.

If you are a motivated and ambitious US Medical Billing professional with a passion for Billing industry, we want to hear from you! Apply now to join our team as an “Team Lead US Medical Billing”.

Share your latest resume / CV to Ibtesam@7kctech.com

Job Type: Full-time

Pay: From Rs100,000.00 per month

Work Location: In person