
Billing Process Optimization Specialist
6 days ago
Job Description
We are seeking an experienced Medical Billing Operations Lead to join our team. As a key member of our medical billing operations team, you will be responsible for overseeing and optimizing the revenue cycle process, ensuring efficient medical billing operations while maintaining compliance with healthcare regulations.
Key Accountabilities:
- Operational Excellence: Develop and implement strategies to optimize billing processes, reduce claim denials, and improve cash flow.
- Team Guidance: Lead, mentor, and supervise remote medical billing teams, ensuring productivity targets and quality benchmarks are consistently met.
- Client Liaison: Act as the primary point of contact for clients, addressing inquiries, resolving issues, and providing regular performance reports and updates.
- Compliance Assurance: Ensure billing practices comply with healthcare regulations (e.g., HIPAA, payer policies) and maintain high accuracy and quality control standards.
- KPI Monitoring: Track and report key performance indicators (KPIs) such as Days in AR, Clean Claim Rate, and Denial Rate, and provide actionable insights for improvement.
- Staff Training: Organize training sessions and continuous development programs for team members to keep them updated with the latest payer policies and coding changes.
- Error Mitigation: Proactively identify potential risks or errors in billing processes and implement corrective action plans to mitigate revenue loss.
- Cross-Functional Alignment: Work closely with coding teams, credentialing specialists, and revenue cycle management (RCM) teams to ensure smooth end-to-end operations.
- System Implementation: Recommend and assist in the implementation of medical billing software and tools to enhance team efficiency and data security.
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