Lead PFS Medical Billing Specialist

📋 Description

• Serve as a subject matter expert and first-level escalation resource for complex medical billing
• Accurately prepare and submit claims while ensuring compliance with payer requirements, applicable
• Research payer policies, contracts, guidelines, and complex claim issues, and communicate relevant
• Analyze complex billing discrepancies and account issues, identify root causes, develop solution
• Work closely with revenue cycle departments, provider representatives, departmental leaders, and
• Act as a proxy for the department manager when needed and provide quality reviews, workflow

🎯 Requirements

• Have a high school diploma or equivalent; an associate degree is preferred.
• Bring approximately 4 years of non-clinical healthcare experience, preferably within revenue cycle
• Demonstrate strong knowledge of hospital and professional billing practices, payer guidelines
• Have substantial experience researching and resolving complex billing questions, claim
• Understand payer policies and contracts and be able to translate changes and requirements into
• Demonstrate experience with claims processing, timely filing requirements, account resolution

🎁 Benefits

• Fully remote work for candidates residing in eligible states: Alabama, Colorado, Florida, Georgia
• Full-time Monday-to-Friday schedule with 40 working hours per week.
• Opportunity to take on a senior, lead-level role within patient financial services and medical
• Leadership and mentoring responsibilities across medical billing teams.
• Exposure to complex healthcare revenue cycle operations, payer relationships, compliance, audits
• Opportunities to lead training, onboarding, PFS projects, and continuous improvement efforts.