Team Leader
1 week ago
Role & responsibilities
Team Management & Delivery
- Lead a team of 812 DME billing associates; manage rostering, shift discipline, and daily huddles.
- Allocate work, monitor queues, track SLAs/KPIs, and drive productivity and quality improvements.
- Conduct coaching, floor support, and monthly performance reviews; manage skill-building and cross-training.
Operational Excellence (DME Billing)
- Oversee eligibility/benefits checks, prior auths, charge entry, claim submission, payment posting (ERA/EOB), AR follow-up, and denials/appeals.
- Ensure adherence to payer-specific rules for DMEPOS: HCPCS Level II, ICD-10-CM, modifiers (e.g., KX, GA, GZ, RR, NU), capped rentals vs. purchase, same/similar checks, and order documentation requirements.
- Review edits/rejections, analyze root causes, and implement corrective actions to improve first-pass yield.
Quality, Compliance & Documentation
- Maintain SOPs/work instructions; enforce HIPAA and client data-security protocols.
- Run audits on samples for accuracy and compliance; publish CAPA where deviations occur.
- Prepare and share daily/weekly MIS: productivity, quality, DSO, denial trends, aging buckets, and recovery.
Stakeholder Communication
- Serve as first point of contact for internal leadership regarding production/quality status, risks, and escalations.
- Coordinate with client POCs on clarifications, payer policy updates, and process enhancements.
Preferred candidate profile
- Advanced Excel for reporting (pivot tables, lookups) and data-driven decision-making.
- Exposure to DME software/EHRs (e.g., Brightree, Kareo, or similar).
- Strong written and verbal communication, with crisp client-facing updates.
- Analytical problem-solving, coaching mindset, and change management capability.
KPIs You Will Own
- Clean-claim rate & first-pass resolution rate
- Denial rate and recovery TAT
- AR aging (030/3160/61–90/90+) & DSO
- Productivity per FTE and audit quality score
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