Billing / Follow Up Lead

General Summary

• The Billing and Follow-up Lead supports timely, accurate claim submission and resolution in accordance with payer requirements and internal policies. This role monitors claim quality, audits accounts and workflows, answers billing questions from patients, staff, and insurance companies, and follows up on claims through final processing. The position requires hospital/professional billing expertise, proficiency with relevant computer systems, strong organization, attention to detail, professionalism, and the ability to manage multiple priorities.

Minimum Qualifications

Required Licensure or Certification

• None required.

Required Length and Type of Experience

• Minimum three years of hospital or professional billing experience.

Education, Knowledge, Skills and Abilities

• High school diploma or equivalent.

• Proficiency with computer systems used for hospital billing and patient accounting (experience with specific EPIC preferred)

• Knowledge of healthcare patient accounting and health insurance coverage.

• Ability to maintain confidentiality and communicate effectively, both verbally and in writing.

• Ability to use standard office equipment properly.

Required Physical and Environmental Demands

• Ability to sit and use a computer for extended periods, including the manual dexterity required for sustained computer work.

Responsibilities

• Partner with Manager, Coordinator, and other Leads to identify training needs and assist in developing standard operating procedures (SOPs) for the PFS department.

• Onboard, train, and mentor billing staff on complex claims and internal workflows.

• Monitor held claims to ensure timely submission

• Conduct routine audits on accounts to ensure all billing and follow-up procedures are executed properly.

• Stay up-to-date on third-party billing regulations and contract filing demands.

• Prepare written documentation for proper billing and follow-up procedures.

• Identify problem accounts with third-party payers; investigate, correct errors, and resubmit claims.

• Resolve outstanding, unpaid, and/or unprocessed claims.

• Utilize A/R reports and EOBs to identify and resolve outstanding third-party claims.

• Perform all job duties in full compliance with ARMC’s Corporate Compliance Program and Code of Conduct.

Benefits:

• Competitive salary package
• Extensive benefit package including medical, dental, vision, and life insurance (Benefits on Day 1!)
• Accident & critical illness insurance
• Tuition Reimbursement
• Short-Term & Long-Term Disability Insurance
• Paid Maternity Leave
• Employee Assistance Program
• Paid Time Off
• Employee Wellness Plan that pays you for being healthy
• 403(b) and Roth Retirement Plan with company matching
• We are a qualifying employer for the Public Service Loan Forgiveness (PSLF) Program which allows you to receive forgiveness of the remaining balance of your Direct Loans after you have made 120 qualifying monthly payments while working full-time for a qualifying employer