The Lead Billing Specialist provides operational oversight to the billing team to ensure accurate and timely claim submission for hospital and physician services. This role monitors performance indicators, resolves billing edits, and mentors staff to optimize reimbursement and maintain compliance.
The auditor will perform charge capture reconciliation audits to ensure compliance with health system policies and report findings via scorecards. They will also assist departmental leadership in developing corrective action plans and maintaining expertise on third-party billing regulations.
The Senior Reimbursement Analyst manages net revenue integrity, prepares annual cost reports, and coordinates audits for Medicare and Medicaid. They also provide analytical support for financial planning, maintain reserve models, and recommend process improvements for reimbursement services.
The Manager is responsible for overseeing denial management functions, including researching, analyzing, and resolving revenue cycle rejections. They also lead performance improvement projects, manage staff development, and ensure compliance with federal, state, and third-party regulations.
The Coding Specialist reviews medical record documentation to assign accurate diagnostic and procedural codes for a multi-specialty physician group. They are responsible for maintaining coding accuracy, managing claims edits, and ensuring compliance with regulatory guidelines.
The Code Edit Analyst performs daily coding reviews on claims to validate ICD-10, CPT, and HCPCS codes while ensuring compliance with medical necessity requirements. They also develop reports and process improvement initiatives to resolve billing errors and optimize revenue cycle performance.
The Coding Specialist reviews medical record documentation to assign accurate diagnostic and procedural codes for a multi-specialty physician group. They are responsible for maintaining coding accuracy, managing claims edits, and ensuring compliance with regulatory guidelines.
The Team Lead oversees credit balance resolution staff, providing training and monitoring daily workflows to ensure accurate reconciliation of accounts. They are responsible for resolving complex credit balances, undistributed payments, and refund requests while maintaining compliance with regulatory and contractual requirements.
