Billing Team Lead

Position is hybrid. Candidate must be able to come into office. 

Position Summary

Reporting to the Billing Manager, the Billing Team Lead supports daily billing operations while providing guidance and oversight to Billing Specialists and CPC staff. This role ensures timely and accurate claim submission, monitors team performance, and supports denial management and accounts receivable follow up.

The Billing Team Lead acts as a bridge between staff and leadership, reinforces compliance, and drives workflow improvements.

Responsibilities

Operational Oversight

• Monitor daily claim submission for accuracy and timeliness.
• Review claims for coding and payer compliance before escalation.
• Ensure adherence to timely filing limits across all payers.
• Support resolution of claims on hold within required timelines.

Denial Management

• Guide staff in reviewing, correcting, and resubmitting denied claims.
• Track denial trends and escalate patterns to the Billing Manager.
• Ensure denials are addressed within30 days.

Accounts Receivable Management

• Monitor aging reports and prioritize follow up on accounts over90 days.
• Support efforts to maintain AR benchmarks below 15 percent.
• Assist with oversight of payment posting and patient refund workflows.

Team Leadership and Development

• Provide daily guidance to Billing Specialists and CPC staff.
• Support onboarding and training of new team members.
• Assistwith staff education on coding accuracy and payer requirements.
• Reinforce workflows, policies, and performance expectations.

Performance Monitoring

• Track team KPIs and productivity metrics.
• Assistwith scorecard reviews and performance improvement plans.
• Identifyworkflow gaps and recommend solutions to leadership.

Compliance and Quality Improvement

• Ensure compliance with federal, state, and MCO requirements.
• Participate in CQI initiatives and process improvement efforts.
• Stay current on payer updates and communicate changes to staff.

Provider and Internal Collaboration

• Support provider education on documentation and coding alignment.
• Assistwith resolving escalated billing and payer issues.
• Collaborate with clinical and administrative teams to improve workflows.

Systems and Workflow Management

• Maintain strong proficiency in billing platforms and EMR systems.
• Utilizeclaimsscrubbers and reporting tools to reduce denials.
• Support workflow tracking and task management processes.

Key Performance Indicators (KPIs)

• AR over 90 days: Less than 15 percent
• Denial resolution within30 days
• Claims on hold resolved within 10 business days
• 90 percent claim collection rate
• Monthly scorecard performance of 80 percent or higher
• Patient refunds processed within 5 business days

Education/Experience/Licensure   

• High School diploma or equivalent required
• Certified Professional Coder (CPC) is preferred
• Experience in medical billing within an FQHC or similar setting is preferred
• Strong knowledge of coding guidelines, payer requirements, and denial workflows
• Prior experience mentoring or leading staff preferred
• Proficiency in billing systems and EMR platforms
• Strong organizational skills, ability to manage multiple tasks, and proficiency in billing software, EHR, and Microsoft Office 365 is required

Benefits

• Medical, Dental, Vision and Life Insurance
• Flexible Spending Accounts with Medical and Dependent Care
• Voluntary Life Insurance
• 401(k) Salary Deferral and Match
• Paid Time Off 
• Paid Holidays
• Employee Assistance Program
• Employee Discounts
• Employee Referral Program