Lead Billing Specialist, Professional Billing (Hybrid)

Hours: 40 hours per week; Monday through Friday from 8:00 AM to 4:30 PM

Location: Hybrid model; 2 days onsite at 55 Technology Drive in Lowell, MA is required.

Job Profile Summary 

​This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing.  In addition, this role focuses on performing the following Billing related duties: Bills patients for administered care, handles incoming payments, calculates patient intake costs, and tracks accounts receivable to ensure accuracy. Responsibilities also include working with patients to arrange special payment options when necessary.  An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a “hands on” environment.  The majority of time is spent in the delivery of support services or activities, typically under supervision.  A specialist level role that requires very advanced knowledge of operational procedures and tools obtained through extensive work experience and may require vocational or technical education.  Works under limited supervision for non-routine situations and may be responsible for leading daily operations, and trains, delegates and reviews the work of lower level employees, and problems are typically difficult and non-routine but not complex. 

Job Overview 

This position is responsible for monitoring work volume, creating workflows, identifying trends and escalation needs as well as training/coaching their team on billing and accounts receivable responsibilities. Performs accounts receivables resolution, including but not limited to, registration and eligibility verification, claim edits, payer follow-up, correspondence review, corrected claims, appeals, reimbursement verification, and remittance research for assigned scope of receivables. 

Job Description 

Minimum Qualifications: 

1. High school diploma or equivalent. 

2. Three (3) years of experience in a hospital billing and collection environment for a medical services provider or third-party payor. 

Preferred Qualifications: 

1. Completion of a medical terminology course and understanding of CPT and ICD diagnosis coding. 

2. Certified Revenue Cycle Representative (CRCR). 

3. Epic certifications. 

4. Five (5) years of experience in a hospital billing and collection environment for a medical services provider or third-party payor. 

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list.  Other duties and responsibilities may be assigned. 

1. Prepares and holds training sessions with billing team and prepare for and attend meetings as requested by supervisor and manager. 

2. Monitors of work volumes in conjunction with supervisors as needed if a training/system issue/escalated account arises. 

3. Identifies trends in workflows and rework, and reports outstanding operational issues to management for further research and reso