Remote Lead Billing Specialist – Claims & Revenue Leader

ECU Health; Greenville (NC); Remote; USD 26,000 - 38,000; Full time

Benefits offered by this job

Remote role

Great Benefits

Job summary

ECU Health in Greenville, NC is seeking a Lead Billing Specialist to provide operational oversight and lead the Billing Specialist team to ensure accurate, compliant, and timely claim submission for hospital and physician services.

You will supervise daily workflow, monitor key performance indicators, identify trends, and implement process improvements to optimize reimbursement and clean claim rates while training and mentoring staff.

Qualifications

• 7+ years of electronic billing and/or billing edit experience in hospital and/or physician setting.
• 1-2 years leadership, senior specialist, or mentoring experience preferred.
• Working knowledge of HCPCS, CPT-4, ICD-10, and medical terminology.
• Strong understanding of payer requirements and claims processing regulations.

Responsibilities

• Oversees daily pre-bill and post-bill edit resolution to ensure timely claim release.
• Monitors workqueues, claim scrubber edits, and billing reports to ensure productivity and quality standards are met.
• Ensures claims are submitted within payer timely filing guidelines.
• Prioritizes workload to meet departmental KPIs (Clean Claim Rate, DNFB/Pre-AR Days, Initial Denial Rate, Timely Filing).
• Reviews billing-related denials to identify trends and implement corrective action plans.
• Monitors hardcopy claim processing and supporting documentation requirements.
• Escalates payer issues appropriately and partners with leadership to resolve systemic barriers.
• Ensures accurate use of UB-04 and CMS-1500 claim forms and required data elements.
• Conducts quality audits of team members' work and provides feedback for improvement.
• Leads rebill projects and coordinates special initiatives assigned by leadership.

Skills

Leadership

Billing systems

Payer requirements

Medical terminology

Education

High School Diploma

Tools

Epic Resolute

Job description

ECU Health in Greenville, NC is seeking a Lead Billing Specialist to provide operational oversight and lead the Billing Specialist team to ensure accurate, compliant, and timely claim submission for hospital and physician services.

You will supervise daily workflow, monitor key performance indicators, identify trends, and implement process improvements to optimize reimbursement and clean claim rates while training and mentoring staff.