Medical Billing Team Lead

All Care To You

Medical Billing Lead mentoring billing coordinators and managing complex claims. Ensuring accurate resolution of pending claims for healthcare clients while providing guidance and support.

Posted 5/20/2026full-timeRemote • California • 🇺🇸 United StatesSenior💰 $22 - $26 per hourWebsite

Tech Stack

Tools & technologies

Azure

About the role

Key responsibilities & impact

Mentor other team members in the details of their assigned health plan, providing answers to questions and direction when needed
Review provider escalations and provider resolution or escalation to management as needed
Review complex patient accounts requiring identification of duplicate claims, corrected claims, overpayments, underpayments, and other issues and work them to resolution
Conduct timely and accurate follow-up on professional services claims to ensure all requested information has been submitted and claims are being processed utilizing payor portals, secure chat, secure messaging, and telephone calls
Identify missing payments from the health plan and assists in researching/locating payments
Review incoming correspondence from health plans and takes appropriate action or escalates to designated team members as needed
Identify pending claims and determines next steps required to obtain reimbursement for claim
Use existing queries to review limited new denials for processing errors, appropriately assigns a status based on review, corrects any internal errors and resubmits claims as necessary
Follow up with insurance carriers, providers, or other stakeholders to gather additional information or documentation required for claims resolution
Monitor incoming messages from providers and respond to the provider or escalates the request to the appropriate team member
Assist with special claims research projects as assigned
Document all interactions and updates in the claims management system
Maintain accurate records of claim status, actions taken, and resolutions utilizing established policies and procedures
Prepare and submit reports on claim follow-up activities and status updates to management as requested
Ensure all claims follow-up activities comply with company policies, industry regulations, and legal requirements
Stay updated on changes in insurance policies, regulations, and industry standards
Must meet quantitative production standard of working 75 - 125 claims per week
Attend departmental and company meetings as required
Identify and report trends which could have an overall negative impact on claim payments such as processing errors, denials, or billing issues
Investigate and resolve discrepancies or issues related to claims processing and payment
Work with other team members and departments ensure proper claim submission
Identify and recommend process improvements to enhance the efficiency and effectiveness of the claims follow-up process
Participate in training and development opportunities to stay current with best practices and industry trends.

Requirements

What you’ll need

A minimum of 5 years’ experience as a medical biller or similar role
Excellent technical skills including the ability to work in multiple systems simultaneously and learn new systems quickly
EZ-Cap experience preferred
Electronic Data Interchange (EDI) Clearinghouse (Office Ally) experience preferred
Microsoft Suite – Outlook, Teams, Office365, OneNote, OneDrive, SharePoint
Sequel Server Management Studio
Confluence
Azure
Thorough knowledge of healthcare benefits, network participation, coordination of benefits, referral and authorization requirements, and insurance follow up
Working knowledge of CPT Codes, ICD-10 Codes, Modifiers, MUE, LCD, NCD, and CCI edits
Must have strong time management skills, be able to multi-task, resolve problems utilizing critical thinking, be detail oriented and highly organized
Ability to work in a fast-paced environment while maintaining strict confidentiality
Excellent written and verbal communication skills.

Benefits

Comp & perks

100% employer paid medical, vision, dental, and life coverage
Paid holiday
Sick time
Vacation time
401k plan
Additional employee paid coverage options

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

medical billingclaims processingCPT CodesICD-10 CodesModifiersMUELCDNCDCCI editsclaims resolution

Soft Skills

time managementmulti-taskingproblem solvingcritical thinkingdetail orientedhighly organizedwritten communicationverbal communication