Lead Medical Billing Spec-Remote Job Hamilton Ohio USA,Healthcare

Position: LEAD MEDICAL BILLING SPEC-REMOTE

To manage the accounts receivable for timely and maximum reimbursement by adhering to company billing and collection policies. In addition the team lead, will review coding & charges, ensure the completion of team members daily task, and follow-up with external and internal customers to ensure the remediation of customer issues that may arise. The team lead should communicate with the AR Manager concerning central billing issues, questions, concerns, corrective actions or training needs.

Team

Leader Responsibilities and Duties

Coding/Charge Review

Ensure Team Members are completing tasks/job functions timely
Coders receive charges from centers
Coders code charges within 1 day/24 hours of receipt of charge from centers
Coded charges/charge slips to Charge Entry team same day as coding completed
Charge Review team defers any charge not accepted with notes indicating why the charge is deferred
Work with CBO AR Manager to develop a common (all CBO centers) way for each center to report charges (surgery, hospital rounding, etc.)
Work with CBO AR Manager/CBO Administrator to implement coding education for CBO staff

Customer Service

Faxes, mail and courier items distributed immediately (utilizing mail boxes at front door rather than interrupting staff at work stations)
Charges received via fax are batched using a Batch cover sheet
Batch is logged into the Extraction Log on the CBO Shred Drive
Batch is delivered to the correct coding staff member’s mailbox
Hardcopy and Secondary Claims printed daily
Verify BWC claim/info is correctly processed

Charge Entry

Ensure team members are completing tasks/job functions timely
Manual charge entry batches are being received promptly from coding
Charges are keyed into Epic within 1 day/24 hours of receiving from Coding
Extraction Log is completed once batch is keyed into Epic
Determine that work/charges to be keyed are evenly distributed to each team member
Each team member is expected to inform team leader when they are behind
Check/Spot check team members’ work for errors

Payment Posting

Ensure team members are completing tasks/job functions timely and according to guidelines
Payments are posted within 24 hours of deposit to bank
Payments batches are balanced to EPIC daily, utilizing the PB Payment Activities report
Spreadsheets are balanced to bank every Monday; if team member is off on Monday, balancing to be performed the day before PTO begins
Reconciliation items from previous month are posted prior to beginning current month’s payment posting
Verify that team members are saving their work to the CBO shared drive
Lockboxes
- Daily
Bank balancing spreadsheet
- Weekly
Spreadsheets
- As updated
Check/Spot check team members’ work for errors
Perform audits as requested by CBO AR Manager/CBO Administrator and randomly (determine if payment posted has difficulty with balancing and audit frequently)
Work with ERA Claims Specialist to resolve missing ERAs for entire team
Verify that ERAs are posted using Check Member not just deposit amount

Follow Up

Ensure team members are completing tasks/job functions timely and according to guidelines
WQs are current according to guidelines
Credit WQs are being worked at least one hour per day
ROA payments are distributed within 24 hours of center collecting payment
Check /Spot check team members’ work for errors
Work with CBO AR Manager/CBO Administrator to redistribute responsibilities to accommodate new staff member and to ensure work is evenly distributed
Verify that information is being deferred correctly and all encounters that are deferred have notes indicating why it is deferred

All Team Functions

Report an updates, concerns, issues during weekly Team Lead meetings
Answer questions from team members and center staff
Educate/Inform staff regarding changes, updates, etc
Monitor team members use of work time to handle personal business (Socializing with co-workers, Personal phone calls)
Communicate Roadblocks/Issues to CBO AR Manager
Ensure consistency among staff, workflow, etc.
Cross Train/ “Buddy Billers”

Other duties as assigned by CBO AR Managers/CBO Administrator

Qualifications

High School diploma or GED

Three to five years previous healthcare billing, collections experience, and/or managed care experience preferred

Knowledgeable about third party billing regulations and CPT.
4/ICD.
9/10 coding

Routine CRT/data entry skills

Knowledge of spreadsheet applications

Proven record of dependability

Strong communication and decision‑making skills

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