What are the responsibilities and job description for the Billing Lead position at Northwest Medical Center Tucson?
Seeking a full time remote Billing Specialist Lead to support our and Resource department at Tucson Surgery Center.
Job Summary
The Billing Lead is responsible for assigning daily workflow, assisting billers, and assisting in the coordination and reporting of information between the SSC (Shared Services Center) management and the hospital CFO(s).
Essential Functions
- Analyzes and reviews billing reports, claim submissions, and payor reconciliations to identify and resolve issues.
- Assists with developing and maintaining billing rules to prevent claims denials and optimize revenue cycle efficiency.
- Manages daily claim translations, ensuring accurate claim submission and thorough follow-up on SSI balancing and correspondence.
- Serves as a resource to the follow-up and denials team, providing guidance on claim specifics and necessary follow-up actions.
- Communicates effectively with internal teams and external payors to resolve claim issues and provide detailed explanations on claim status.
- Monitors and responds to payor rejections, identifying trends and implementing corrective measures.
- Maintains accurate and timely documentation within workflow systems, staying current on insurance carrier guidelines and payor requirements.
- Performs other duties as assigned.
- Complies with all policies and standards.
Qualifications
- H.S. Diploma or GED required
- 2-4 years of experience in billing, accounts receivable, or revenue cycle management within a healthcare setting required
- 1-3 years of experience as a team lead and/or a supervisory role in a healthcare setting, medical revenue-cycle focused including billing, follow-up, and/or denial resolution preferred
Knowledge, Skills and Abilities
- Proficiency in healthcare billing practices and insurance processes.
- Strong analytical skills and attention to detail for reviewing billing reports and claims.
- Excellent verbal and written communication skills.
- Proficiency in relevant software and systems, such as SSI or similar claim processing systems.
- Ability to manage multiple tasks and prioritize effectively.
- Strong problem-solving skills and a collaborative approach to resolving billing issues.
