Lead Biller

General Function

The Lead Biller works collaboratively with clinical, front office, credentialing,

coding, finance, and leadership teams to optimize revenue cycle performance while

supporting the mission of providing high-quality healthcare services to underserved

populations.

Position Overview

The Lead Biller is responsible for overseeing the daily operations of the billing

department while actively participating in all aspects of medical billing and claims

processing. This position serves as the primary resource for billing staff by providing

guidance, training, quality assurance, and workflow coordination to ensure timely and

accurate claim submission, payment posting, denial resolution, and compliance with

all federals, state, payer, and FQHC regulations.

Key Responsibilities

· Serve as the day-to-day lead for the billing team by assigning work,

monitoring productivity and providing ongoing support.

· Train, mentor, and onboard new billing staff

· Assist with employee performance evaluations and provide coaching

when needed.

· Monitor workloads to ensure billing deadlines are met.

· Develop and maintain departmental billing procedures.

 · Serve as the subject matter expert for billing policies and payer requirements.

· Promote teamwork and continuous process improvement.

· Maintain active certification with approved credentialing agency

· Collect/process/Identify patient/payer payments, complaints and concerns

· Make recommendations to management regarding policy, workflow, and staffing changes

· Evaluate patients’ financial status and establish budget payment plan

· Follows and reports status of delinquent accounts

 · Perform various collection actions including contacting patients, correcting and resubmitting claims to third party payers

· Participate in educational activities and attend monthly staff meetings

· Conducts annual training courses in accordance with NHA’s employee manual

· Maintains strict confidentiality; adheres to all HIPPAA guidelines/regulations

· Train medical staff and front desk when necessary to assure proper claim submission.

· Develops and precipitate in provider and staff training on coding best practices to ensure good flow and clean claim submission

· Remain current with coding changes provide recommendations for process flow changes according to best practices and billing standards

· Research correct codes and new codes to ensure maximum revenue opportunity

· Main point of contact with outsourced billing company to increase revenue and eliminate duplicate coding errors

· Provide staff with tools to ensure charts are documented according to billing standards and in accordance with compliance standards.

· Prepare quarterly audits for organization in accordance with best practices for patient chart documentation.

· Review HEDIS measures with the quality team to support best practices for reimbursement and value-based care (VBC) submissions.

Qualifications

· Must have a coding certification from an approved credentialing body.

· 3-5 years of experience in a physician or hospital billing environment

· 2-4 years of coding experience

· Advanced knowledge of medical billing/collection practices

· Advanced Knowledge of business office procedures

· Must be well organized and detail-orientated

· Must be able to keep staff engaged in daily activities

Who We Are

Neighborhood Health Association (NHA) is Northwest Ohio’s largest community health center system. Since 1969, we’ve grown to 13+ clinics offering medical, dental, pediatric, women’s, senior, and homeless care—plus a full-service pharmacy and lab. We focus on prevention and helping people take charge of their health.

Our Mission

Through our exceptional health care services, we empower and educate, aggressively working to eliminate health care inequities, while supporting personal responsibility for one’s own health regardless of the ability to pay.

Join Our Team

We are a drug free workplace, and an Equal Opportunity Employer