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About the Role

The Jr. Medical Billing Lead is responsible for the financial performance, claim quality, and client relationships for an assigned portfolio of medical billing clients. This role manages a smaller portfolio than senior leads while maintaining performance standards and providing day-to-day direction and support to Billing Specialists.

Responsibilities

Own collections performance for the assigned client portfolio, including underpayments and appeals.
Work aged A/R based on revenue impact, prioritizing high-dollar balances and accounts at risk of timely filing.
Identify revenue leakage from missed charges, underpayments, and payer contract variances.
Escalate contract-level issues to the National Billing Manager.
Review payment posting and adjustment accuracy for assigned accounts.
Drive first-pass claim acceptance through front-end edits, payer rule maintenance, and scrubber configuration.
Categorize denials by root cause and implement corrective action at the source.
Maintain compliance with payer requirements, coding standards, and applicable billing regulations.
Escalate systemic compliance risks and high-dollar exposure to the National Billing Manager.
Absorb newly onboarded accounts and bring them to steady-state billing performance.
Coordinate with implementation, credentialing, and coding teams to configure billing workflows for new accounts.
Validate payer setup, fee schedules, and claim configuration before first submission and go-live.
Document account-specific billing requirements and maintain accurate client records.
Audit a monthly sample of Billing Specialist work for accuracy and adherence to billing standards.
Provide day-to-day direction, training, and workflow support to assigned Billing Specialists.
Address performance gaps directly and escalate unresolved issues to the National Billing Manager.
Support onboarding and cross-training of new billing staff.
Lead scheduled client meetings for assigned accounts.
Deliver monthly performance reporting covering collections, denials, and A/R, including commentary on variances and corrective actions.
Resolve billing disputes with clients and payers promptly and document resolutions.
Escalate at-risk accounts to the National Billing Manager as soon as risk is identified.

Requirements

Minimum of three years of experience in medical billing or revenue cycle, including direct ownership of client accounts and A/R follow-up.
Working knowledge of CPT, ICD-10, and HCPCS coding.
Knowledge of payer adjudication rules, denial management, and applicable billing regulations.
Demonstrated ability to guide, train, and hold accountable a remote or geographically dispersed team.
Proficiency with billing software, clearinghouse platforms, and financial reporting tools.
Ability to interpret A/R aging, denial, and collections data and take appropriate action based on findings.
Ability to work independently and manage competing priorities across multiple client accounts.
Understand the full revenue cycle from charge capture through payment posting and appeals.
Demonstrate a thorough understanding of operational procedures and their impact on other departments.
Demonstrate extensive understanding of general and department-specific regulations, including payer requirements and coding standards.
Interpret billing data to distinguish isolated errors from systemic issues and prioritize work based on revenue impact.
Maintain professional communication and positive client relationships.
Communicate performance results and unfavorable information candidly and without delay.
Build morale and foster collaboration toward shared objectives.
Provide direct, specific feedback and hold staff accountable to defined standards.
Demonstrate a strong understanding of technology used in billing operations and consistently identify opportunities to improve efficiency through technology.
Ability to stand and/or sit for periods of time.
May be required to walk, reach, lift, carry, and bend.
Must be able to lift and/or move up to 10 lbs. and occasionally more than 10 lbs.
Ability to perform small movements with the fingers, including typing, handling small objects, and similar activities.
Ability to accurately convey information verbally to clients and other employees.
Ability to hear average or normal conversations and receive ordinary information.
Requires close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus.

Skills

Medical Billing
Revenue Cycle Management
A/R Follow-up
CPT Coding
ICD-10 Coding
HCPCS Coding
Payer Adjudication Rules
Denial Management
Billing Regulations
Team Leadership
Training
Accountability
Billing Software Proficiency
Clearinghouse Platforms
Financial Reporting Tools
Data Interpretation
Client Relationship Management
Performance Reporting
Problem Solving
Communication
Collaboration
Computer Skills
Typing

Experience Level

Minimum of three years of experience in medical billing or revenue cycle

Education Level

Bachelor’s degree in Accounting, Finance, Healthcare Administration, or a related field, or equivalent medical billing experience.