Medical Billing Team Lead

Job not on LinkedIn

🕒 May 20

🏄 California – Remote

🏄 California – Remote

💵 $22 - $26 / hour

⏰ Full Time

🟠 Senior

🏥 Medical Billing and Coding

Apply Now

Find Similar Remote Jobs

Receive Emails For Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

All Care To You

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2018

Management Service Organization (MSO)

📋 Description

• Mentor other team members in the details of their assigned health plan, providing answers to questions and direction when needed • Review provider escalations and provider resolution or escalation to management as needed • Review complex patient accounts requiring identification of duplicate claims, corrected claims, overpayments, underpayments, and other issues and work them to resolution • Conduct timely and accurate follow-up on professional services claims to ensure all requested information has been submitted and claims are being processed utilizing payor portals, secure chat, secure messaging, and telephone calls • Identify missing payments from the health plan and assists in researching/locating payments • Review incoming correspondence from health plans and takes appropriate action or escalates to designated team members as needed • Identify pending claims and determines next steps required to obtain reimbursement for claim • Use existing queries to review limited new denials for processing errors, appropriately assigns a status based on review, corrects any internal errors and resubmits claims as necessary • Follow up with insurance carriers, providers, or other stakeholders to gather additional information or documentation required for claims resolution • Monitor incoming messages from providers and respond to the provider or escalates the request to the appropriate team member • Assist with special claims research projects as assigned • Document all interactions and updates in the claims management system • Maintain accurate records of claim status, actions taken, and resolutions utilizing established policies and procedures • Prepare and submit reports on claim follow-up activities and status updates to management as requested • Ensure all claims follow-up activities comply with company policies, industry regulations, and legal requirements • Stay updated on changes in insurance policies, regulations, and industry standards • Must meet quantitative production standard of working 75 - 125 claims per week • Attend departmental and company meetings as required • Identify and report trends which could have an overall negative impact on claim payments such as processing errors, denials, or billing issues • Investigate and resolve discrepancies or issues related to claims processing and payment • Work with other team members and departments ensure proper claim submission • Identify and recommend process improvements to enhance the efficiency and effectiveness of the claims follow-up process • Participate in training and development opportunities to stay current with best practices and industry trends.

🎯 Requirements

• A minimum of 5 years’ experience as a medical biller or similar role • Excellent technical skills including the ability to work in multiple systems simultaneously and learn new systems quickly • EZ-Cap experience preferred • Electronic Data Interchange (EDI) Clearinghouse (Office Ally) experience preferred • Microsoft Suite – Outlook, Teams, Office365, OneNote, OneDrive, SharePoint • Sequel Server Management Studio • Confluence • Azure • Thorough knowledge of healthcare benefits, network participation, coordination of benefits, referral and authorization requirements, and insurance follow up • Working knowledge of CPT Codes, ICD-10 Codes, Modifiers, MUE, LCD, NCD, and CCI edits • Must have strong time management skills, be able to multi-task, resolve problems utilizing critical thinking, be detail oriented and highly organized • Ability to work in a fast-paced environment while maintaining strict confidentiality • Excellent written and verbal communication skills.

🏖️ Benefits

• 100% employer paid medical, vision, dental, and life coverage • Paid holiday • Sick time • Vacation time • 401k plan • Additional employee paid coverage options