Lead Healthcare Biller

5 days ago

Los Angeles, California, United States Oxford Health Group Full time

NOW HIRING: Lead Healthcare Biller / Billing Team LeaD

Horizon Repecurative Care is a pillar for providing care to the homeless in the community of Los Angeles, CA. We approach every day with one goal: To improve the lives we touch through high-quality healthcare and extraordinary compassion.

10900 South Vermont Ave

Los Angeles, CA 90044

Job Summary:

We are seeking a highly experienced and solutions-oriented Lead Healthcare Biller to guide our Revenue Cycle team. This senior role is responsible for overseeing the daily operations of the billing staff, ensuring the timely and accurate submission of medical claims, and driving continuous process improvement. The ideal candidate will be an expert in healthcare billing, a critical thinker capable of resolving complex reimbursement challenges, and a proactive leader who can create and implement effective billing solutions to optimize our revenue cycle.

Key Responsibilities:

  • Provide day-to-day guidance, training, and oversight to the billing staff, acting as the first point of escalation for questions and complex issues.
  • Lead critical thinking and problem-solving initiatives to identify root causes of claim denials, payment delays, and billing inefficiencies.
  • Design, create, and implement new billing workflows, solutions, and internal processes to enhance accuracy, efficiency, and compliance.
  • Act as a key architect in the development and refinement of internal billing workflows and RCM tools.
  • Oversee and ensure the accurate preparation and submission of clean claims to insurance companies and third-party payers.
  • Manage and resolve escalated, complex claim denials and rejections by researching and correcting systemic billing errors.
  • Analyze A/R aging reports, identify negative trends, and develop solutions to reduce days in accounts receivable.
  • Collaborate with clinical staff, coders, and other departments to ensure accurate documentation, census, and billing.
  • Serve as a senior liaison to insurance companies and patients to resolve high-level billing inquiries and discrepancies.
  • Maintain expert-level knowledge of payer guidelines, billing regulations, and compliance standards (e.g., HIPAA), and ensure the team is updated.
  • Lead departmental preparation for internal and external audits and assist with generating advanced reports.

Qualifications:

  • High school diploma or equivalent; Associate's degree or certification in medical billing/coding preferred.
  • 4-5+ years of progressive experience in healthcare billing or medical claims processing.
  • Demonstrated ability in critical thinking and complex problem-solving within a healthcare revenue cycle.
  • Proven experience in developing and implementing billing processes.
  • Proficiency in billing software and electronic health record (EHR) systems.
  • Strong knowledge of medical terminology, coding systems (ICD-10, CPT), and insurance processes.
  • Excellent attention to detail, organizational skills, and leadership qualities.
  • Strong communication and interpersonal skills for training and team collaboration.

Preferred Skills:

  • Prior experience in a senior, team lead, or supervisory role.
  • Certification in Medical Billing and Coding (e.g., CPC, CPB, or equivalent).
  • Expertise in Medicare/Medicaid and commercial insurance billing.
  • Familiarity with HIPAA regulations and healthcare compliance standards.
  • Experience with revenue cycle management platforms (e.g., Epic, PCC, NextGen).

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