Lead PFS Medical Billing Specialist

This is a fully remote position, open to applicants in Alabama, +15 more states.

📋 Description

• Work collaboratively with managers to analyze current processes and drive improvements.

• Act as the project manager for PFS initiatives, including ongoing training and education for staff.

• Create, develop, and implement onboarding and training programs for caregivers.

• Function as a proxy for the manager and carry out quality reviews.

• Provide mentorship to members of the Medical Billing Team and serve as the first escalation point.

• Review and assess complex claims, investigating payer guidelines while collaborating with provider representatives and departmental leaders.

• Develop and maintain documentation for processes and workflows.

• Investigate and resolve intricate billing inquiries, discrepancies, claim errors, and rejections.

• Research payer policies and contracts, delivering updated information to PFS teams and leadership.

• Work with revenue cycle departments to address billing and compliance challenges.

• Participate in or lead PFS meetings and coordinate follow-up actions.

• Foster relationships with PFS departments and provider representatives.

• Analyze and resolve account and systematic issues.

• Ensure billers adhere to the correct account-processing procedures and steps.

• Guarantee accurate billing, timely filing, month-end reconciliation, and compliance with payer guidelines.

• Assist with special projects, audits, reports, and departmental reporting tasks.

⛳️ Requirements

• Remote work is restricted to candidates residing in Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, or Virginia.

• Intermediate to advanced proficiency in Microsoft applications.

• Exceptional verbal and written communication skills.

• Strong organizational and time management abilities; capable of effectively prioritizing tasks.

• Reliable in terms of productivity and attendance.

• Professional communication skills with both internal and external departments and customers.

• Innovative problem-solving capabilities.

• Competence in researching and reviewing payer policies, guidelines, and compliance standards.

• Knowledge of medical terminology.

• Ability to appropriately escalate issues to leadership.

• Capability to work independently and manage multiple tasks simultaneously.

• Skill to interact virtually with team members.

• Proficiency in analyzing and interpreting data and thoroughly explaining issues.

• Ability to organize data and collaborate effectively to resolve carrier claims processing issues.

• Proficient in operating computers, telephones, fax machines, calculators, and copiers continuously and repetitively.

• High School Diploma - Required.

• Associate's Degree - Preferred.

• Four years of non-clinical healthcare experience, ideally in revenue cycle - Preferred.

• Previous leadership experience is highly preferred.

🏝️ Benefits

• Concierge services.

• Employee lounge.

• Wellness programs.

• Free covered parking.

• Free on-site and virtual health clinics.

• Compensation and recognition.