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Billing Team Leader

Job Title
Billing Team Leader
Job ID
Philadelphia,  PA 19104
Other Location

Description:Responsible for leading the Billing and Coding team, as well as the Document Management Team.  In addition to managing a small team (4 direct reports total, including one biller and one coder), the leader will also perform daily tasks related to charge entry and billing to support timely filing of claims.  This is considered a "player/coach" role.  The ideal candidate will lead their four direct reports and also know how to perform each team member's duties.

Essential Job Functions:

  • Provide support, training, and feedback to teams with suggestions to improve coding accuracy and documentation based on those daily reviews.
  • Work closely with Medical Staff, Physicians, Payors and the Billing Company as required to successfully resolve billing and coding issues.
  • Ability to manage Accounts Receivable
  • Ability to identify and resolve reimbursement and credit balance issues related to all medical insurance payor groups.
  • Knowledge of payment and collection procedures and adjustment processes.
  • Assess work flows to develop company processes and procedures to ensure continuous quality improvement in the billing operations.
  • Provide feedback to appropriate physicians and support staff in regards to incomplete, inaccurate or inconsistent documentation or coding.
  • Compile and Monitor activity/revenue reports as required or requested by finance department and operations for revenue cycle.
  • Review, resolve and report discrepancies or deficiencies of our facilities as related to Physician Billing & Coding.
  • Assure processes and procedures related to all activities are done with the utmost privacy and confidentiality.
  • Research claims flagged with billing and coding denials
  • Access multiple systems and navigates through sites to obtain various levels of information.
  • Manages contracts with partnered insurance carriers (new / termed)
  • Fee schedule management
  • Develops metrics to the efficiency and timeliness of the teams’ performance and identifies opportunities to improve services
  • Supports the Document Management team’s efforts to streamline and improve document management services provided to care teams (currently 2 team members)
  • Works with Clinic Operations Leaders to ensure team’s billing, coding and document management needs are met
  • Works with Quality manager and Coding team to ensure that data is appropriately captured for submission to health plan partners
  • If team members are out of the office, provides direct support for billing, coding and document management operations to ensure continuous services

Essential Job Skills:

  • Ability to demonstrate reliability and responsiveness to members (patients), families and team members.
  • Ability to demonstrate mutual respect and build a trusting environment with members (patients), families and team members.
  • Makes meaningful improvement to services, programs and processes and/or organizational effectiveness that creates new value for members and employees.
  • Establish and maintain good working relationships with various stakeholder groups.
  • Works collaboratively across disciplines and administrative functions across the organization and in the community.
  • Shares and receives information, concerns and feedback in a supportive manner.
  • Ability to participate towards a common goal, reinforcing individual capabilities.
  • Practice shared accountability between members, families, teams and partners.
  • Ability to show empathy.
  • Excellent written and verbal communication skills.
  • Attention to detail and accuracy.
  • Strong interpersonal skills to handle sensitive situations and confidential information.
  • Strong Leadership and Management Skills
  • Knowledge of Medicare, Advantage Plans and Medicaid

Minimum Requirements:

  • Extensive experience performing medical billing and coding in a large physician practice
  • Knowledge and skilled in the use of a computers and related systems and software.
  • 5-7 years of overall experience
  • Five or more years of experience with CPT/ICD 9/ICD 10 coding

Preferred Requirements:

  • Bachelor’s Degree
  • Coding Certification
  • Two or more years' experience in a supervisor or lead biller/coder role

Physical Requirements:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Sitting, standing, walking for much of the day
  • Manual dexterity
  • Lifting up to 30 pounds (may exceed this amount at times in emergency member situations)
  • Bending and reaching