Lead Medical Billing Specialist

Rural Physicians Group is an expansive physician network of rural-focused hospitalist, surgicalist and APPs that are passionate about helping rural hospitals meet the needs of the communities we serve.  By working with Rural Physicians Group, our hospital partners receive full-time dedicated providers on site, filling a critical void in care coverage and allowing for better patient outcomes.  Better outcomes lead to expanded inpatient services. Expanded inpatient services revitalize the hospital.  And a revitalized hospital improves the entire community.

RPG’s mission is, “Bringing rural hospitals and providers together to enhance the care of their community.”

We are currently seeking a full time Lead Medical Billing Specialist to help us with this mission. 

Job Overview:

The Lead Medical Billing Specialist is responsible for overseeing the revenue cycle billing processes, ensuring the billing team is accurately performing their job duties daily. The Lead Medical Billing Specialist must confidently and accurately perform all areas of the billing cycle workflows. This responsibility will be used to train new staff, assist existing staff with training and questions, and understand all reporting and systems utilized by the billing team.

• Supervises the day-to-day revenue cycle processes to ensure accurate billing information is entered, processed, and paid according to our payor contracts.
• Participates in hiring and training staff.
• Monitor patient demographic data entry. Ensure the billing team is obtaining referrals and pre-authorizations as required for procedures.
• Assist the billing team with data entry and ensure 72-hour billing is met promptly. Assist with MaxRVU billing when the coders are offline.  Assist the billing team with the unbilled buckets, ensuring they are working on those pending claims daily.
• Reviewing patient bills for accuracy and completeness and obtaining any missing information.
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Following up on unpaid claims within the standard billing cycle timeframe.
• Ensuring the billing team is properly and promptly identifying and billing secondary or tertiary insurance.
• Reviewing accounts for the insurance of patient follow-up. Reporting any billing errors to management for additional staff training.
• Assisting in payor audits, fee schedule payments, and payment posting job functions. C
• Mentor, coach, and onboard team members to elevate overall team capability and performance
• Serve as a subject matter expert and go-to resource for complex or escalated issues
• Anticipate challenges and propose proactive solutions

Knowledge, Skills, and Abilities

• Experience supervising medical billing staff
• Knowledge of insurance guidelines, including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
• Experience and knowledge with CPT and ICD-10 Coding.
• Effective communication abilities for phone contacts with insurance payers to resolve issues.
• Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
• Ability to work well in a team environment. Being able to triage priorities and reasonably handle conflict.
• Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections.
• Experience and knowledge of accounting and bookkeeping procedures.
• Experience and knowledge of medical terminology are likely to be encountered in medical claims.
• Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Possesses the ability to work in a constantly changing environment
• Good judgment skills, and capable of making decisions with attention to detail.
• Must have excellent organizational skills and ability to prioritize and coordinate workload with high degree of proficiency and accuracy.
• Must have excellent analytical and problem-solving skills.
• Ability to work easily and cooperatively with other departments.
• Ability to work independently and follow through on tasks without direct supervision.
• Ability to work well under pressure in a flexible, diplomatic and expeditious manner.
• Must have excellent written and verbal communication skills
• Must be able to effectively diffuse escalated conversations

Education and Experience Required

• Minimum 3 years of Revenue Cycle experience with Rural Physicians Group
• Must have excellent computer knowledge of Patient Accounting systems
• Bachelor’s degree in accounting, Business, or Finance, or equivalent desired
• Associates or Certification(s) a plus

Benefits:

• Competitive salary
• Incentivized bonus plan
• Ability to work remotely from home 
• Three weeks of paid time off, accrual starting first day
• Comprehensive medical, dental, and vision insurance plans
• 401(k) with company match
• Health Savings Account
• Basic Life Insurance coverage
• Cell Phone Allowance