What are the responsibilities and job description for the Billing Lead position at The Pediatric Development Center?
About the Role
The Billing Lead keeps PDC’s day-to-day billing running accurately and on time. This role leads the billing team’s daily work, is the go-to person for billing questions, and makes sure claims, payments, denials, and appeals are handled with precision and care.
The Billing Lead trains and mentors the Medical Billing Specialists, sets the standard for how Billing work gets done at PDC, and helps each person on the team grow in the role. The Billing Lead follows PDC’s billing processes and helps the team follow them too.
What You’ll Do
Lead and develop the billing team
- Train new Medical Billing Specialists on PDC’s billing processes, payer requirements, and systems and make sure each person is set up to do the work well.
- Mentor and coach the team day-to-day: review work, give feedback, answer questions, and walk through complex claims, denials, and appeals so the team builds skill over time.
- Keep the billing training manual and materials up to date so the team always has current guidance to work from.
- Hold a short weekly billing huddle to review priorities, backlogs, and problem claims.
- Give the CEO input on each team member’s performance, training needs, and readiness for more responsibility. The CEO conducts formal performance reviews.
- Participate in interviewing candidates for billing roles and give the CEO a recommendation.
Lead the billing team’s day-to-day work
- Coordinate daily billing work for the billing team (currently two Medical Billing Specialists), assigning and balancing work so nothing falls through the cracks.
- Serve as the team’s first stop for billing questions and complex or unusual billing situations.
- Make sure team members follow PDC’s billing processes, and flag gaps or problems to the CEO.
- Keep the CEO informed on team workload, backlogs, and issues that need a decision.
Keep claims and revenue moving
- Make sure claims are billed accurately and on time.
- Monitor claim status and follow up on unpaid and denied claims, working directly with insurance carriers to resolve issues.
- Make sure denials are appealed on time and that required documents are on file to support claims and appeals.
- Track that remits are coming in and that payments are posted accurately.
- Make sure insurance companies are reimbursing at the contracted rate and follow up when they are not.
- Make sure billing follows PDC’s payer contracts and addenda and applicable regulations and laws, including Good Faith Estimate requirements under the No Surprises Act.
- Process secondary claims and coordinate billing for patient out-of-pocket expenses.
- Reconcile accounts receivable and keep organized records of billing activity, payments, and correspondence.
- Help with end-of-month reconciliation.
Communicating with families and the team
- Make sure parents are informed about balances, billing questions, and payment plans.
- Make sure families are following the financial agreement they signed and address it with them when they are not.
- Work with therapists, front office, and leadership to keep billing processes clean and efficient.
- Stay current on insurance and HIPAA requirements and share updates so the team stays compliant.
What You Bring
- 5 years of hands-on medical billing experience, with a proven track record in A/R follow-up, claim denials, and appeals.
- Experience leading, training, or mentoring other billers, and a track record of helping a team get better at the work.
- High attention to detail and strong communication and customer service skills.
- Experience with patient balance collection.
- Ability to handle sensitive information with professionalism and discretion.
- A problem-solver who takes initiative and works well independently and with a team.
- Preferred: associate degree or certification in medical billing and coding.
What We Offer
- Medical, dental, and vision insurance (with HSA option)
- Company-paid life insurance and short-term disability
- 401(k) with employer match
- Paid time off and holidays
- Ongoing professional development
Position: Full-time, in person onsite in Rockville, Monday–Friday