TL- Medical Billing

Credense Medical Billing Pvt Ltd; Hyderabad; Sur place; INR 600 000 - 900 000; Plein temps

Résumé du poste

Credense Medical Billing Pvt Ltd is seeking a Medical Billing Team Lead to guide a team of billers, manage workflows, and ensure accurate coding with ICD, CPT, and HCPCS. The role requires strong leadership, regulatory knowledge, and experience with revenue cycle metrics. Proficiency in NextGen is a plus.

The position involves client communication, claim submissions, denials management, and ongoing process improvements to optimize financial performance.

Qualifications

• Experience in medical billing leadership or team management preferred.
• Strong knowledge of ICD, CPT, HCPCS coding.
• Familiarity with HIPAA and billing compliance.
• Ability to analyze KPIs and optimize revenue cycle processes.

Responsabilités

• Team management: lead and manage a team of medical billers, assign tasks, monitor workload and provide feedback.
• Conduct regular team meetings to discuss progress, address challenges, and share updates.
• Provide training and coaching to team members on billing procedures, coding guidelines, and new regulations.
• Review patient records to ensure accurate coding using ICD, CPT, HCPCS.
• Verify insurance eligibility before submitting claims.
• Electronically submit claims to various payers by deadlines.
• Monitor claim statuses, address denials, and initiate appeals when necessary.
• Follow up on outstanding claims to ensure timely payment.
• Analyze billing data to identify trends and areas for improvement in revenue cycle.
• Monitor KPIs such as denial rates, collection rates, and aging of accounts receivable.
• Implement strategies to optimize revenue cycle performance and achieve financial goals.
• Ensure adherence to HIPAA and other billing compliance standards; conduct regular quality audits.
• Stay updated on changes to billing codes, regulations, and payer policies.
• Collaborate with healthcare providers to address billing inquiries and resolve disputes with insurers.
• Provide regular reports on billing performance to stakeholders.
• Experience with NextGen will be an added advantage.

Connaissances

Team management

Training

Coaching

Billing procedures

Regulatory compliance

ICD CPT HCPCS coding

Insurance eligibility

Claims submission

Denials management

Revenue cycle management

KPIs monitoring

Data analysis

Quality audits

HIPAA compliance

Client communication

NextGen

Outils

NextGen

Description du poste

Responsibilities of a Medical Billing Team Lead:

• Team Management:Lead and manage a team of medical billers, assigning tasks, monitoring workload, and providing performance feedback.
• Conduct regular team meetings to discuss progress, address challenges, and share updates.
• Provide training and coaching to team members on billing procedures, coding guidelines, and new regulations.
• Claim Submission and Follow-up:
• Review patient medical records to ensure accurate coding using ICD, CPT, and HCPCS codes.
• Verify insurance eligibility and benefits before submitting claims.
• Electronically submit claims to various insurance payers according to established deadlines.
• Monitor claim statuses, identify and address claim rejections or denials, and initiate appeals when necessary.
• Follow up on outstanding claims to ensure timely payment.
• Revenue Cycle Management:
• Analyze billing data to identify trends and areas for improvement.
• Monitor key performance indicators (KPIs) such as denial rates, collection rates, and aging of accounts receivable.
• Implement strategies to optimize revenue cycle performance and achieve financial goals.
• Compliance and Quality Assurance:
• Ensure adherence to HIPAA regulations and other healthcare billing compliance standards
• Conduct regular quality audits to identify billing errors and implement corrective actions
• Stay updated on changes to billing codes, regulations, and payer policies
• Client Communication:
• Collaborate with healthcare providers and practice management staff to address billing inquiries
• Communicate with insurance companies to resolve billing disputes and negotiate payment terms
• Provide regular reports on billing performance to stakeholders.
• Experience with NextGen will be an added advantage.