Medical Billing Lead

Prime Healthcare; Mesquite (TX); Sur place; USD 65 000 - 90 000; Plein temps

Avantages offerts par ce poste

Health, dental, and vision insurance

Paid vacation

Sick time and holidays

Bereavement leave

401K options

Tuition reimbursement

Résumé du poste

Prime Healthcare's Dallas Medical Physician Group in Mesquite, TX is seeking a Medical Billing Lead to oversee billing, coding, claims follow-up, and reimbursement activities to support revenue cycle operations. The role includes reviewing documentation and coding, educating staff on payer requirements, and assisting with credentialing and process improvement.

Responsibilities include reviewing claims in Epic for accuracy, submitting and following up on insurance and third-party claims, training

Qualifications

• 1. Knowledge of multiple insurance billing requirements and 3-5 years of billing experience
• 2. HIPAA confidentiality requirements and strict privacy
• 3. Knowledge of Epic, Excel, Word, and clearinghouse software
• 4. Knowledge of CPT, HCPCS, ICD-10 coding protocols, Medicaid, third party and Medicare billing
• 5. Knowledge of regulatory standards applicable to the position
• 6. Ability to understand and apply rules, policies and procedures
• 7. Effective communication abilities
• 8. Ability to establish and maintain working relationships with clinicians and patients
• 9. Ability to multi-task and meet timelines
• 10. Analytical problem-solving skills
• 11. Customer service experience
• 12. High School Graduate or GED equivalent

Responsabilités

• Review coding, documentation, and claims in Epic to ensure accurate and compliant billing before submission
• Submit and follow up on insurance, workers’ compensation, HMO/PPO, and other third-party claims through final resolution
• Train and support billing staff, clinicians, and providers on coding guidelines and payer policies
• Monitor charge entry, claim submission, payment posting, denials, and monthly accounts receivable reporting
• Assist with provider and facility credentialing, process development, compliance initiatives, and patient billing concerns

Connaissances

Billing experience

Communication skills

Analytical skills

Multi-tasking

Customer service

Regulatory awareness

Team training

Formation

High School Diploma or GED

Outils

Epic

Excel

Word

Clearinghouse software

Description du poste

Overview

Shifts Available:Days

Employment Type:Full Time

Hours:8hrshifts–7:45am to 4:15pm

Location:Dallas Medical Physician Group–Mesquite, TX

We are seeking aMedical Billing Lead,sometimesreferred to asPhysicianOfficeBilling LeadorLead Medical Billing & Coding Specialist.The Medical Billing Lead oversees billing, coding, claims follow-up, and reimbursement activities to supportaccurateandtimelyrevenue cycle operations.The Medical Billing Lead reviews documentation and coding, resolves claim issues, educates providers and staff on payer requirements, andassistswith credentialing and process improvement. The Medical Billing Lead also supports and trains billing staff whilemonitoringdaily operations, accounts receivable, and compliance with regulatory and payer guidelines.

Responsibilities

• Review coding, documentation, and claims in Epic to ensureaccurateand compliant billing before submission

• Submit and follow up on insurance, workers’ compensation, HMO/PPO, and other third-party claims through final resolution

• Train and support billing staff, clinicians, and providers on coding guidelines, payer policies, and billing processes

• Monitor charge entry, claim submission, payment posting, denials, rejections, and monthly accounts receivable reporting

• Assistwith provider and facility credentialing, process development, compliance initiatives, and resolution of patient billing concerns

Qualifications

1. Knowledge of multiple insurance billing requirements and 3-5years ofbilling experience

2. Knowledge of HIPAA confidentiality requirements, maintains strictest confidentiality.

3. Knowledge of Epic, Excel, Word, and clearinghouse software.

4. Knowledge of CPT, HCPCS, ICD-10 coding protocols, Medicaid, third party and Medicare billing and coding.

5. Knowledge of regulatory standards appropriate for position.

6. Ability to understand and apply applicable rules, regulations, policies and procedures.

7. Ability to communicate effectively.

8. Ability to establish and maintain effective working relationships with clinicians and patients.

9. Ability to multi-task, prioritize needs to meet required timelines

10. Analytical and problem-solving skills.

11. Customer Services experience required

12. High School Graduate or GED equivalent Required

Here are some of the benefits of working at Prime Healthcare:

• Health, dental, and vision insurance options

• Paid vacation, sicktimeand holidays

• Bereavement leave, FMLA and other leave options

• Employer 401K options

• Tuition reimbursement options

• Life, disability, and other insurance options

• Many other amazing benefits

Full benefits at Prime Healthcare:https://www.primehealthcare.com/careers/benefits/

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights:https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf