Medical Records Biller IV- Lead

Koniag Advisory Business Solutions, LLC, a Koniag Government Services company is seeking a Medical Records Biller IV Lead to support KABS and our government customer in Oklahoma, OKC. This position requires the candidate to be able to obtain a Public Trust.

This position is covered under the Service Contract Act. We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, paid holidays, paid vacation, paid sick leave and more.

This is a hybrid position based in Oklahoma City, Oklahoma. We anticipate July 1 as the project kick-off date. During the first few weeks of onboarding and initial training, employees are required to work on site full-time, Monday through Friday, 8:00 a.m. to 5:00 p.m. CT, at 701 Market Dr, Oklahoma City, OK 73114. Core working hours are generally 9:00 a.m. CT to 3:00 p.m. CT, with exact start and end times determined by the Program Manager.

Work hours may flex based on client needs.

Based on demonstrated proficiency and successful performance in all areas of responsibility, employees may become eligible for telework. Telework is a temporary privilege and may be modified or rescinded at any time due to operational, client, business, or security requirements.

• Maintain a dedicated, secure home office workspace.
• Maintain a reliable high‑speed internet connection.
• Reside within a reasonable commuting distance of Oklahoma City.
• Report to the office at least twice every two weeks, and more often as needed for meetings or business requirements.

The Medical Biller IV (Lead) performs advanced billing and account‑receivable functions for outpatient and inpatient claims and serves as a lead‑level individual contributor within the billing team. This role handles complex billing scenarios, supports denial management and appeals, assists with audits and payer reviews, helps refine billing procedures, and provides mentoring and technical guidance to junior staff while maintaining hands‑on production responsibilities.

• Oversees preparation and submission of complex outpatient and inpatient claims to third‑party payers, intermediaries, and responsible parties in accordance with required timelines and internal controls.
• Reviews daily system reports and monitors claim inventory to ensure timely processing, export, and transmission.
• Responds to post‑payment reviews, exclusions, denials, and appeals and assists with medical reviews and claim‑level audit activity.
• Ensures daily billing productivity reporting is accurate and that unbillable claims are identified, documented, and elevated appropriately.
• Verifies that electronic billing transmissions are HIPAA compliant and that reconciliation and correction activities are completed promptly.
• Maintains current knowledge of payer guidance, listserv updates, policy changes, and continuing education resources.

• Performs advanced review of medical records to validate diagnoses, dates of service, provider signatures, attestation requirements, and documentation needed to support claim submission.
• Identifies trends, discrepancies, and documentation issues and coordinates with providers, billing staff, and other departments to resolve problems before claims are transmitted.
• Guides eligibility verification and insurance‑identification review activities for complex cases and supports resolution of coverage issues.
• Supports preparation and compilation of authorizations, benefits assignments, release forms, and pre‑certification documents needed for payer approval and claim support.
• Refers appropriate patients to Benefits Coordination or Social Services and helps staff navigate complicated eligibility situations.

• Reviews patient records and billing data for outpatient and inpatient services and supports accurate sequencing of ICD, CPT, and HCPCS codes used in billing.
• Ensures provider documentation supports billed diagnoses, procedures, and E&M levels and resolves discrepancies affecting reimbursement.
• Monitors inpatient daily census and ADT‑related issues and coordinates with…