Lead Billing Specialist, IPN, Full Time

ICFAI; Statesville (NC); On-site; USD 52,000 - 68,000; Full time

Job summary

ICFAI in Statesville, NC seeks a Lead Billing Specialist to oversee daily billing operations, train staff, and ensure accurate, timely claim submission to maximize reimbursement.

You will audit coding accuracy (ICD-10/CPT), manage AR, resolve escalated denials, and monitor payer trends while ensuring HIPAA compliance.

Qualifications

• 3–5 years of professional medical billing experience with leadership exposure.
• Proficiency in ICD-10 and CPT coding and payer guidelines.
• Experience with HIPAA compliance and AR management.

Responsibilities

• Train and mentor new hires, provide side-by-side coaching, and assist with maintaining and updating billing procedure manuals.
• Prepare and submit claims electronically or on paper to private health and state insurers; contact payers to correct issues.
• Review remittances and take actions including follow-up and error correction for re-billing.
• Re-bill denied and pending claims to achieve successful completion.
• Conduct regular audits of team data entry for accuracy and HIPAA compliance; enforce regulations.
• Serve as primary contact for complex billing disputes, denials, and patient complaints.
• Monitor aging reports and payer trends; identify systemic issues delaying claims.
• Create and maintain reports tracking billings, collections, and outcomes.
• Identify billing errors from transactions; report on status of all billing activity.
• Assist management with coordinating revenue cycle duties across functions.
• Data validate and submit for non-billing state reporting requirements.
• Review patient records daily for accuracy and compliance with policies and regulations.
• HIPAA — help secure medical records and ensure patient confidentiality.
• Access patient records as needed for physician and staff review.
• Follow professional standards and comply with local, state, and federal laws.

Skills

Medical billing

Leadership

Cerner

ICD-10

CPT

Payer guidelines

Attention to detail

Education

High School diploma or GED

Tools

Cerner

Job description

Description

A Lead Billing Specialist oversees the daily operations of the billing team, ensuring accurate, compliant, and timely submission of claims to maximize reimbursement. Key duties include training staff, auditing records for coding accuracy (ICD-10/CPT), managing accounts receivable (AR), and resolving escalated claim denials.

• Train and mentor new hires, provide side-by-side coaching, and assist with the maintaining and updating of billing procedure manuals.
• Prepare and submit claims, either electronically or by paper, to private health and County/State insurance companies. Contact insurance companies to correct billing issues and resubmit claims to third-party payers.
• Review remittances and take appropriate actions including:
• Perform follow-up and error correction to support re-billing of denied claims.
• Re-bill denied and all claims to a successful completion.
• Conduct regular audits of team data entry to ensure accuracy and strict adherence to HIPAA and other federal regulations.
• Serves as the primary point of contact for complex billing disputes, difficult insurance denials, and patient complaints.
• Monitors aging reports, tracks payer trends (e.g., Medicare, Medicaid, private insurers), and identifies systemic issues causing claim delays.
• Create and maintain reports from the application database by tracking billings; monitoring collections; compiling information.
• Identify billing errors by interpreting transactions. Follow and report on status of all billing transactions.
• Assists medical billing management with coordinating various billing functions to ensure proper execution of billing revenue cycle duties.
• Perform data validation and submission for other non-billing State reporting requirements.
• Review patient records daily for accuracy, supply any missing information and ensure compliance with company policy and government regulations.
• HIPAA - Assist in establishing and maintaining security of medical records to ensure patient confidentiality on an ongoing basis.
• Access patient records as needed for review by physicians, technicians and other medical staff members.
• Follow professional standards and meet requirements of local, state and federal regulations.
• Other duties as assigned.

Description

A Lead Billing Specialist oversees the daily operations of the billing team, ensuring accurate, compliant, and timely submission of claims to maximize reimbursement. Key duties include training staff, auditing records for coding accuracy (ICD-10/CPT), managing accounts receivable (AR), and resolving escalated claim denials.

• Train and mentor new hires, provide side-by-side coaching, and assist with the maintaining and updating of billing procedure manuals.
• Prepare and submit claims, either electronically or by paper, to private health and County/State insurance companies. Contact insurance companies to correct billing issues and resubmit claims to third-party payers.
• Review remittances and take appropriate actions including:
• Perform follow-up and error correction to support re-billing of denied claims.
• Re-bill denied and all claims to a successful completion.
• Conduct regular audits of team data entry to ensure accuracy and strict adherence to HIPAA and other federal regulations.
• Serves as the primary point of contact for complex billing disputes, difficult insurance denials, and patient complaints.
• Monitors aging reports, tracks payer trends (e.g., Medicare, Medicaid, private insurers), and identifies systemic issues causing claim delays.
• Create and maintain reports from the application database by tracking billings; monitoring collections; compiling information.
• Identify billing errors by interpreting transactions. Follow and report on status of all billing transactions.
• Assists medical billing management with coordinating various billing functions to ensure proper execution of billing revenue cycle duties.
• Perform data validation and submission for other non-billing State reporting requirements.
• Review patient records daily for accuracy, supply any missing information and ensure compliance with company policy and government regulations.
• HIPAA - Assist in establishing and maintaining security of medical records to ensure patient confidentiality on an ongoing basis.
• Access patient records as needed for review by physicians, technicians and other medical staff members.
• Follow professional standards and meet requirements of local, state and federal regulations.
• Other duties as assigned.

Requirements

• High School graduate or GED.
• Three - Five years of professional medical billing experience, with one – two years in leadership or senior role preferred
• Proficiency working in electronic health record systems (i.e. Cerner)
• Extensive knowledge of medical terminology, coding systems (ICD-10, CPT), and payer guidelines.
• Knowledge of basic medical professional coding and third-party operating procedures and practices.
• Ability to operate a computer, basic office equipment and multi-line telephone system.
• Must be well organized and detail oriented.

Essential Physical Requirements

• Must possess full range of body motion to pass basic FIT test for position to include walking, kneeling, standing, pushing, pulling, bending, stooping, reaching and sitting for extended periods of time.
• Must be able to lift and carry up to 25 pounds
• Manual dexterity needed for using a calculator and computer keyboard.