Physician Billing Team Lead

Overview

The Accounts Receivable (AR) Team Lead at Riverside Healthcare plays a pivotal role in overseeing all billing and collection activities related to insurance accounts receivable. This position, under indirect supervision, is responsible for the coordination, training, and mentoring of the AR team members, ensuring accurate and timely processing of insurance claims and follow‑ups. The AR Team Lead acts as a key resource for all departments within the health system, offering expertise in contracted insurance payers, coding, and fostering a collaborative team environment.

This role also emphasizes adherence to patient satisfaction principles and requires the ability to perform additional tasks as assigned and demonstrates flexibility with assignments within professional scope/duties/licensure.

• Team Leadership & Training:
  Lead, train, and mentor the AR team, ensuring all members are equipped with the necessary skills and knowledge to perform their duties effectively.
• Billing & Collections:
  Oversee all billing and collection activities related to insurance accounts receivable, ensuring accuracy and compliance with established procedures.
• Claims Management:
  Handle complex insurance denials, perform root cause analysis, and implement corrective actions to reduce and prevent future denials. Engage in appeals processes to secure payment resolution.
• Process Improvement:
  Identify and recommend opportunities for improving customer service, system processes, and overall efficiency. Partner with management to implement necessary changes.
• Compliance & Standards:
  Ensure adherence to HIPAA privacy standards and compliance with patient health information privacy practices in all communications. Maintain an understanding of evolving payer classifications and reimbursement policies.
• Coding & Documentation:
  Review and resolve coding‑related denials, correcting CPT, ICD‑10, and HCPCS codes as needed. Maintain coding compliance and stay updated with recognized coding guidelines and billing requirements.
• Collaboration:
  
  Actively participate in payer calls, provide feedback to payer representatives, and escalate issues as necessary. Keep the manager informed of progress, achievements, and any issues that arise.
• Productivity & Quality:
  Run staff productivity, perform monthly audits, and provide feedback to staff.
• Special Projects:
  Assist with special projects and other duties as assigned, as necessary.
• Continuing
  
  Education:
  
  Participate in trainings and seminars as assigned by the Patient Accounting Manager to stay current with industry standards and improve job performance.

• Assist with other administrative duties or tasks as assigned by management.
• Support cross‑functional teams as needed for comprehensive billing and collection processes.

• Completion of ICD‑10 and CPT coding courses from AAPC or AHIMA is required.
• 2‑3 years of experience in collections, claims follow‑up, or denials required.

• Experience in a physicians office or other healthcare setting preferred.
• Knowledge of insurance and authorization processes is helpful.
• Previous experience with EPIC is preferred.
• Understanding of the hospital or physician revenue cycle is preferred.

• High School Diploma or equivalent required.
• Certified Coder required or must obtain within 6 months of hire.

• Strong analytical and problem‑solving skills.
• Excellent communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Proficiency in maintaining confidentiality and adhering to privacy regulations.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Riverside Healthcare offers a comprehensive suite of Total Rewards: benefits and nationally rated employee well‑being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more…