
Team Lead – Medical Billing
2 weeks ago
We are looking for a highly skilled and responsible Team Lead – U.S. Medical Billing, Insurance Authorization & Office Operations with proven experience working with U.S. medical offices. The ideal candidate will have in-depth expertise in medical billing, insurance verification, and authorization processes (including Personal Injury Protection – PIP), along with knowledge of Letter of Medical Necessity (LOMN) procedures and pharmacokinetic analysis. This individual must demonstrate strong leadership capabilities to manage and supervise an entire office while ensuring compliance, efficiency, and high-quality performance.
Key Responsibilities:
- Team Leadership & Office Supervision
- Lead and manage the medical billing and call center teams, ensuring smooth day-to-day operations.
- Supervise staff performance, assign tasks, provide training, and maintain accountability.
- Foster a professional, results-driven work culture with focus on accuracy and compliance.
- Medical Billing & Revenue Cycle Management (RCM)
- Oversee the full billing cycle: charge entry, claim submission, payment posting, denial management, and collections.
- Ensure proper use of CPT, ICD, and HCPCS coding in compliance with U.S. healthcare standards and HIPAA regulations.
- Monitor Accounts Receivable (A/R) and implement strategies to reduce denials and improve collections.
- Insurance Authorization & Verification
- Conduct insurance verification and eligibility checks for patients across multiple payers.
- Handle pre-authorizations, prior authorizations, and Personal Injury Protection (PIP) insurance cases.
- Coordinate with insurance carriers to secure approvals and resolve claim-related issues.
- Specialized Medical Support
- Manage Letter of Medical Necessity (LOMN) preparation and submission for treatments and prescriptions.
- Support providers and patients with pharmacokinetic analysis processes and documentation.
- Call Center & Patient Interaction
- Oversee inbound/outbound calls regarding billing, insurance, and patient queries.
- Ensure excellent communication, patient support, and issue resolution.
- Track and improve call center KPIs such as FCR, AHT, and customer satisfaction.
- System & Portal Management
- Utilize and oversee work on leading medical portals/software such as AdvancedMD, Availity, Epic, and others.
- Maintain accurate records, reports, and dashboards for management review.
- Reporting & Compliance
- Generate regular performance reports on billing, denials, collections, and team productivity.
- Ensure strict compliance with HIPAA, payer policies, and U.S. healthcare regulations.
Requirements:
- Bachelor's degree in Healthcare Administration, Business, or a related field (preferred).
- Minimum 4–6 years of experience in U.S. medical billing, insurance authorization/verification, and office operations.
- Proven expertise in Personal Injury Protection (PIP) cases, LOMN preparation, and pharmacokinetic analysis.
- Hands-on experience with billing portals such as AdvancedMD, Availity, Epic (must).
- Strong leadership skills with prior experience managing teams or supervising office operations.
- Excellent English communication skills (written & verbal).
- Responsible, dedicated, and able to work under pressure with minimal supervision.
Job Type: Full-time
Pay: Rs200, Rs250,000.00 per month
Work Location: In person
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