Team Lead, Billing

CarepathRx; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company is seeking a Team Lead for Billing to manage third-party billing and collections. The ideal candidate will possess strong communication and problem-solving skills, with knowledge of medical billing practices and payer guidelines. Responsibilities include ensuring accurate billing, managing inquiries, and training new employees. A comprehensive benefits package is offered for full-time employees.

Benefits

Medical/Dental/Vision

Flexible Spending

401(k)

Paid Time Off

Paid Holidays

Qualifications

• Medical billing experience with knowledge of ICD10, HCPCS preferred.
• Familiarity with third-party payer guidelines and reimbursement practices.

Responsibilities

• Manage billing and collections to ensure timely payment.
• Answer billing inquiries from patients and insurers.
• Submit claims to appropriate insurance carriers.

Skills

Customer Service

Communication

Problem Solving

Attention to Detail

Education

Associate Degree

Tools

Microsoft 365

Job description

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

The Team Lead, Billing is responsible for managing third-party billing and collections, ensuring timely and accurate billing of claims. This role involves billing medical and NCPDP claims, identifying and resolving root cause of rejections, with the goal of resolving discrepancies and maximizing reimbursement. The ideal candidate will have knowledge of home infusion, medical billing practices, and payer reimbursement guidelines, as well as strong communication and problem-solving skills. The position requires attention to detail, the ability to work independently, and proficiency with Microsoft 365. Experience with ICD-10, CPT-4, HCPCS, and Medicare billing is preferred.

Responsibilities

• Manage all fiscal functions necessary to ensure the prompt and correct payment of all monies owed by both insurers and patients.

• Answer billing and insurance inquiries on patient accounts from patients, insurance companies and other departments.

• Knowledgeable and responsible for multiple payers.

• Maintain, correct, and reconcile batch posting for any or all payers as requested by the Supervisor.

• Prepare adjustments that are necessary to change existing accounts receivable to update patient information.

• Review billing edit report to identify and perform data edits needed to ensure that claims are submitted to the correct payer and that all required information is included.

• Submit claims to appropriate insurance carriers or organizations to obtain payment for services provided.

• Utilize billing software to confirm orders for billing.

• Assist all front-line workers with questions/issues.

• Primary trainer for all new employees and any existing employees who are learning a new function.

• Assist Supervisor and Manager with making sure all current priorities and initiatives are being followed .

• Manage billing projects to ensure timely completion.

• Monitor unbilled to ensure old batches are worked as priority .

• Work with Supervisor /Manager to ensure the end of month is done in a timely manner.

• Be SME ( Subject Matter Expert) for all payers.

• Other duties as assigned.

Skills & Abilities

• Strong customer service and interpersonal skills

• Effective written and verbal communication

• Excellent organization, problem solving skills and attention to detail.

• Meet the quality assurance and benchmark standards set by the management team.

• Knowledge of patient accounting systems, third party billing and collections guidelines

• Ability to communicate with patients, payers and outside agencies through telephone, electronic and written correspondence.

Requirements

• Associate degree preferred.

• Medical billing experience with an understanding of ICD10, HCPCS and medical terminology is preferred.

• Familiarity with third party payer guidelines, reimbursement practices and available financial resources is preferred.

• Knowledge of Medicare guidelines for Home Infusion.

• Proficiency in the Microsoft Suite.

CarepathRx offers a comprehensive benefit package for full-time employees that includesmedical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits,401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire .

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.