Job Description

Overview

Shifts Available: Days

Employment Type: Full Time

Hours: 8hr shifts – 7:45am to 4:15pm

Location: Dallas Medical Physician Group – Mesquite, TX

We are seeking a Medical Billing Lead, sometimes referred to as Physician Office Billing Lead or Lead Medical Billing & Coding Specialist. The Medical Billing Lead oversees billing, coding, claims follow-up, and reimbursement activities to support accurate and timely revenue cycle operations. The Medical Billing Lead reviews documentation and coding, resolves claim issues, educates providers and staff on payer requirements, and assists with credentialing and process improvement. The Medical Billing Lead also supports and trains billing staff while monitoring daily operations, accounts receivable, and compliance with regulatory and payer guidelines.

Responsibilities

• Review coding, documentation, and claims in Epic to ensure accurate and compliant billing before submission
• Submit and follow up on insurance, workers’ compensation, HMO/PPO, and other third-party claims through final resolution
• Train and support billing staff, clinicians, and providers on coding guidelines, payer policies, and billing processes
• Monitor charge entry, claim submission, payment posting, denials, rejections, and monthly accounts receivable reporting
• Assist with provider and facility credentialing, process development, compliance initiatives, and resolution of patient billing concerns

Qualifications

1. Knowledge of multiple insurance billing requirements and 3-5 years of billing experience
2. Knowledge of HIPAA confidentiality requirements, maintains strictest confidentiality.
3. Knowledge of Epic, Excel, Word, and clearinghouse software.
4. Knowledge of CPT, HCPCS, ICD-10 coding protocols, Medicaid, third party and Medicare billing and coding.
5. Knowledge of regulatory standards appropriate for position.
6. Ability to understand and apply applicable rules, regulations, policies and procedures.
7. Ability to communicate effectively.
8. Ability to establish and maintain effective working relationships with clinicians and patients.
9. Ability to multi-task, prioritize needs to meet required timelines
10. Analytical and problem-solving skills.
11. Customer Services experience required
12. High School Graduate or GED equivalent Required

Here are some of the benefits of working at Prime Healthcare:

• Health, dental, and vision insurance options
• Paid vacation, sick time and holidays
• Bereavement leave, FMLA and other leave options
• Employer 401K options
• Tuition reimbursement options
• Life, disability, and other insurance options
• Many other amazing benefits

Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

#LI-MM5