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Hospital Medical Billing Team Lead
1 month ago
Job Summary:
We are seeking a detail-oriented and experienced Hospital Denials and Follow-up Biller to manage denied claims, resolve billing issues, and optimize revenue recovery. The ideal candidate will have strong analytical skills, excellent communication abilities, and proficiency in hospital billing processes and software.
Key Responsibilities:
- Claim Review: Analyze and review denied claims, identify denial trends, and determine reasons for denials.
- Appeal Preparation: Prepare and submit appeals for denied claims, ensuring the inclusion of all required documentation.
- Follow-up: Conduct timely follow-up on outstanding claims and appeals, ensuring prompt resolution and payment.
- Collaboration: Work closely with supervisors, the denials team, insurance companies, and internal departments to resolve denied claims efficiently.
- Documentation: Maintain accurate records of denied claims, appeals, and resolutions in the billing system.
- Regulatory Compliance: Stay updated on healthcare regulations, insurance policies, and payer requirements to ensure compliance and prevent future denials.
- Reporting: Generate detailed reports on denial trends and recovery rates, providing insights for process improvements.
- Issue Resolution: Identify issues leading to underpayments and take corrective actions to ensure accurate billing and revenue recovery.
Qualifications:
- Education: Bachelor's degree in Healthcare Administration, Business, or a related field.
- Experience: A minimum of 5 years of industrial experience in hospital billing, denials management, and claims follow-up.
- Skills: Strong analytical and problem-solving abilities, proficient in billing software and Microsoft Office Suite, particularly Excel and Word, familiarity with medical terminology, CPT, ICD-10 coding, and payer policies, excellent verbal and written communication skills, and strong attention to detail.
Work Environment:
- Fast-paced hospital billing environment with regular interaction with insurance companies, billing teams, and internal departments.
- Opportunities for professional development and process improvement involvement.
