The Role
Lead Billing Specialist oversees daily billing workflow, resolves billing disputes with patients and insurers, enters charges, files claims, processes ERAs/payments/adjustments, audits patient financials, reviews delinquent balances, handles credit balances, and runs reports for management and accounting while ensuring HIPAA and corporate compliance.
Summary Generated by Built In
The Billing Lead actively assists with problem solving and conflict resolution with team members, customers, and insurance companies. Assists with organizing and assigning daily workflow within the team. Reads and evaluates healthcare receivables reports and identify.
Responsibilities- Adheres to and supports the mission, purpose, philosophy, objectives, policies, and procedures of Tenet Physician Resources.
- Adheres to the Tenet HIPAA Compliance Plan and the Privacy Standards Confidentiality Agreement.
- Demonstrates support for the Tenet Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner.
- Enter charges in a timely manner
- File claims and run/work audit trails daily
- Process ERAs, payments, and adjustments
- Balance daily activity- Prepare and send Batch Cover Sheet to Director and accounting
- Ensure that front office staff properly collects copays and balances due at time of service by auditing patient financial data up to 2 days before visit
- Review/work delinquent insurance and patient balances
- Work credit balances . Run reports as requested by management or accounting
Education: HS diploma, GED required
Experience: Must have a minimum of 4 years of experience working in medical billing
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Skills Required
- High school diploma or GED
- Minimum 4 years experience in medical billing
- Knowledge of HIPAA and corporate compliance responsibilities
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The Company
