Remote - Lead PFS Medical Billing Specialist

The PFS Medical Billing Specialist Lead's general responsibilities include but are not limited to:

•    Performs as a proxy for the department manager as needed
•    Participates and coordinates productivity and quality program standards as needed
•    Participates and coordinates payer meetings as needed
•    Performs as a subject matter expert to caregivers for account resolutions
•    Ensures and stays up to date on hospital and/or clinic compliance with all state and federal regulations and reports suspected compliance issues to the department manager
•    Plans, coordinates, and implements on boarding efforts for new caregivers
•    Organizes and implements initial and on-going staff training and education in collaboration with the department leader as needed to drive departmental performance.  This includes but is not limited to: One-on-One training sessions, group training sessions, and educational meetings for new and updated payer guidelines.
•    Assists departmental leaders in establishing, implementing and verifying adherence to controls that maintain appropriate billing and reimbursement practices
•    Acts as a mentor to any caregiver within the organization
•    Works regularly with all revenue cycle departments to analyze and resolve accounts
•    Ensure month-end reconciliation reports are completed accurately each month
•    Assists the department manager in compiling reports as needed
•    Accurately bill claims 
•    Ensure timely filing deadlines are met for various payers 
•    Adequately bill claims per compliance and payer guidelines 
•    Collaborate with various areas of revenue cycle and the organization to ensure accurate and timely billing of claims 
•    Stay current on compliance and payer policies and share information with other caregivers within the organization
•    Act as a mentor to caregivers in the Medical Billing Specialist I and II roles
•    Participates in team activities, trainings and/or educational meetings
•    Identifies trends and root causes to issues
•    Escalates trends with solution proposals
•    Proactively researches and understands payer issues
•    Collaborates with payer representatives regarding compliant claim submissions
•    Assists with special projects, audits and reports
•    Provides extensive analysis and research for complex claim errors and rejections
•    Identifies solutions to complex claim errors and rejections
•    Projects enthusiasm and energy in all efforts