Lead PFS Medical Billing Specialist

Jobgether SRL; El Paso (TX); Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Fully remote work for eligible states

40-hour work week

Senior leadership role in PFS and医cal

Job summary

Jobgether SRL seeks a Lead PFS Medical Billing Specialist in the United States to provide senior-level leadership in patient financial services and medical billing. You will ensure accurate, compliant claim submission while mentoring staff and driving continuous improvement across revenue cycle operations.

Responsibilities include escalation handling, complex billing analysis, payer liaison, and cross-functional collaboration to maintain high standards of quality, productivity, and compliance.

Qualifications

• High school diploma or equivalent; associate degree preferred.
• Approximately 4 years of non-clinical healthcare experience, preferably in revenue cycle, medical billing, or patient financial services.
• Strong knowledge of hospital and professional billing practices, payer guidelines, and regulatory standards.
• Experience researching and resolving complex billing questions, claim discrepancies, errors, and rejections.
• Ability to translate payer policies and contract changes into practical guidance for billing teams.
• Experience with claims processing, timely filing requirements, account resolution, reconciliation, and compliant billing practices.
• Strong analytical and problem‑solving skills with ability to identify trends and root causes.
• Ability to train colleagues, facilitate educational sessions, and support onboarding across departments.
• Excellent organizational skills to manage projects, documentation, and multiple priorities.
• Leadership experience preferred, especially mentoring billing teams or coordinating initiatives.
• Comfort with compliance controls, processes, and healthcare revenue cycle environments.
• Ability to work independently while escalating issues and maintaining communication with managers.
• Available for full-time Monday-to-Friday schedule (~40 hours/week).

Responsibilities

• Serve as subject matter expert and escalation resource for complex billing questions and errors.
• Accurately prepare and submit claims while ensuring compliance and timely filing.
• Research payer policies and communicate updates to teams and leadership.
• Analyze billing discrepancies, identify root causes, and propose solutions.
• Collaborate with revenue cycle, provider representatives, and payer contacts to resolve issues.
• Provide quality reviews and mentoring for Billing Specialist I and II.
• Coordinate productivity and quality programs, staff training, and onboarding.
• Develop onboarding programs and ongoing training for staff.
• Create and maintain process and training documentation for consistency.
• Assist leadership in implementing controls for accurate billing and reimbursement.
• Support month-end reconciliations, audits, and departmental reporting.
• Map processes, identify improvements, and drive workflow changes.
• Lead PFS meetings; capture actions and coordinate with stakeholders.
• Maintain relationships across PFS, hospital, revenue cycle, and provider teams.
• Monitor/state/federal compliance; escalate concerns as needed.
• Promote dependable and collaborative team culture.

Skills

Leadership

Mentoring

Communication

Training

Problem solving

Education

High school diploma

Associate degree preferred

Job description

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Lead PFS Medical Billing Specialist based in United States. This role provides senior-level leadership and subject matter expertise within the patient financial services and medical billing function. You will help ensure accurate, compliant, and timely claim submission while supporting complex account resolution and payer-related issues. The position combines hands‑on billing expertise with mentoring, training, quality oversight, process improvement, and cross‑functional collaboration. You will serve as a key escalation point for complex billing questions, claim errors, rejections, and compliance concerns. The role also contributes to departmental initiatives, audits, reporting, onboarding, and continuous improvement across revenue cycle operations. It is well suited to an experienced healthcare billing professional who can work independently while helping teams maintain high standards of quality, productivity, and compliance.

Accountabilities

• Serve as a subject matter expert and first-level escalation resource for complex medical billing questions, account issues, claim errors, rejections, and caregiver concerns.
• Accurately prepare and submit claims while ensuring compliance with payer requirements, applicable regulations, and timely filing deadlines.
• Research payer policies, contracts, guidelines, and complex claim issues, and communicate relevant updates to billing teams and leadership.
• Analyze complex billing discrepancies and account issues, identify root causes, develop solution proposals, and upgrade recurring trends appropriately.
• Work closely with revenue cycle departments, provider representatives, departmental leaders, and payer representatives to resolve billing, reimbursement, compliance, and account issues.
• Act as a proxy for the department manager when needed and provide quality reviews, workflow oversight, and mentoring for Medical Billing Specialist I and II team members.
• Coordinate and support productivity and quality programs, payer meetings, PFS initiatives, staff training, educational sessions, and departmental projects.
• Design, develop, and implement onboarding programs for new caregivers as well as ongoing training and education for existing staff.
• Create and maintain process, workflow, and training documentation to support consistent execution and continuous learning.
• Assist departmental leadership in establishing, implementing, and verifying controls that promote accurate billing and appropriate reimbursement practices.
• Ensure month‑end reconciliation reports are completed accurately and assist with departmental reporting, audits, special projects, and analysis as needed.
• Collaborate with management to map existing processes, identify improvement opportunities, implement changes, and support development plans designed to improve departmental standards and workflows.
• Attend or lead appropriate PFS meetings, capture follow‑up actions, and coordinate with leadership and relevant stakeholders to drive timely resolution.
• Maintain effective internal and external relationships across PFS, hospital, clinic, revenue cycle, and provider teams to support operational initiatives.
• Monitor compliance with state and federal requirements and elevate suspected compliance issues to departmental leadership.
• Promote a dependable, collaborative, and energetic approach to production, attendance, training, problem solving, and team activities.

Requirements

• Have a high school diploma or equivalent; an associate degree is preferred.
• Bring approximately 4 years of non-clinical healthcare experience, preferably within revenue cycle, medical billing, or patient financial services.
• Demonstrate strong knowledge of hospital and professional billing practices, payer guidelines, reimbursement requirements, and relevant regulatory standards.
• Have substantial experience researching and resolving complex billing questions, claim discrepancies, errors, and rejections.
• Understand payer policies and contracts and be able to translate changes and requirements into practical guidance for billing teams.
• Demonstrate experience with claims processing, timely filing requirements, account resolution, reconciliation, and compliant billing practices.
• Possess strong analytical and problem‑solving skills, with the ability to identify trends, determine root causes, and recommend effective solutions.
• Be comfortable working across multiple revenue cycle functions and collaborating with internal departments, provider representatives, payer contacts, and leadership.
• Demonstrate strong communication and mentoring skills, with the ability to train colleagues, facilitate educational sessions, provide constructive guidance, and support onboarding.
• Have the organizational skills required to manage projects, documentation, follow‑up actions, training activities, and multiple priorities.
• Demonstrate a high degree of ownership, dependability, attention to detail, and commitment to quality.
• Previous leadership experience is highly preferred, particularly experience mentoring billing teams or coordinating departmental initiatives.
• Be comfortable working within established compliance controls, processes, systems, and healthcare revenue cycle environments.
• Be able to work independently while escalating issues appropriately and maintaining effective communication with managers and cross‑functional stakeholders.
• Be available for a full‑time Monday-to-Friday schedule with approximately 40 hours per week.

Benefits

• Fully remote work for candidates residing in eligible states: Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, or Virginia.
• Full-time Monday‑to‑Friday schedule with 40 working hours per week.
• Opportunity to take on a senior, lead‑level role within patient financial services and medical billing.
• Leadership and mentoring responsibilities across medical billing teams.
• Exposure to complex healthcare revenue cycle operations, payer relationships, compliance, audits, and process improvement initiatives.
• Opportunities to lead training, onboarding, PFS projects, and continuous improvement efforts.
• Access to a broad employee benefits and wellness offering, including concierge services, wellness programs, employee resources, and health clinic services.
• Opportunity to contribute to healthcare operations focused on accurate, timely, and compliant patient financial services.