Billing Team Lead (In Office)

Granite VNA is seeking a Billing Team Lead to guide, support, and elevate our billing team while ensuring accuracy, compliance, and efficiency in a fast-paced healthcare environment. This role plays a critical part in supporting our clinicians and patients by keeping revenue processes running smoothly. If you enjoy mentoring others, problem-solving, and contributing to a mission-driven organization that values collaboration and excellence, this may be the perfect opportunity for you. 

Reporting to the Manager of Revenue Cycle the Billing Team Lead oversees the daily operations of the billing team, ensuring accurate, timely invoice processing and claims submissions. The Billing Team Lead is responsible for analyzing data to develop actionable information. Categories include streamlining claim submissions, improving billing accuracy, managing claim denials and drive to reduction, and reducing inefficiencies to streamline workflows. Develop reporting strategies to identify payor performance. The Billing Team Lead will maintain billing tasks for [a population of] payors.

Essential Functions 

Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. 

• Serve as the go-to resource for complex billing discrepancies, customer complaints, and payment issues, communicating with clients and other departments.
• Oversee daily activities of billing team, provide training for new hires and act as a mentor for the billing team members.
• Reviews and categorizes aged receivables for Home Care and Hospice for billing staff workflow.
• Obtains clearinghouse data to accurately report on payor performance
• According to departmental guidelines, analyzes, investigates, and follows-up on denied and/or underpaid claims and patient balances to facilitate payment and resolution. 
• Evaluates payor payments, adjustments and write offs against payor contracts for appropriateness and accuracy. 
• Manages the billing team’s delivery element for patient payor changes.
• Acts as a backup for all billing functions.
• Participates with the billing office staff in review of any outstanding claims and/or denials on a regular ongoing basis to ensure accuracy and timeliness of any necessary appeals.  
• Performs other specific projects relating to billing, data entry, and computer operations as required. 
• Maintains thorough knowledge of payer contracts, regulations and guidelines, as well as State and Federal laws relating to billing and collection procedures to ensure accurate and compliant billing processes. 
• Ensures daily processing Medicare NOA’s and NOE’s. 
• Facilitates process documentation and training and validates consistent process completion.
• Communicate with other departments to obtain necessary information as needed. 
• Represents the billing team along with management in cross-team strategic initiatives.  

Other Job Functions

• Communicate with other departments to obtain necessary information as needed.  
• Represents the billing team along with management in cross-team strategic initiatives.
• Perform job duties in a safe manner to prevent injury to yourself and others
• Demonstrates flexibility in role by accepting other duties as assigned for which qualified. 

Work Environment 

The employee may be required to work extended periods of time using a desktop, laptop and/or other mobile device. No team member is ever required to perform work that he or she believes in unsafe, or that he or she thinks is likely to cause injury or a health risk to themselves or others.  May require work in all office locations.

Expected Hours of Work

The employee will be scheduled to work Monday – Friday: 8am – 4:30pm.    

• High School Diploma or equivalent; Post secondary coursework in Finance, Accounting, or Information Technology preferred or equivalent combination of education and/or work experience required.
• Minimum of 5 years Medicare, Medicaid, or Commercial billing, Home Health and Hospice billing preferred.
• Intermediate to advanced MS Office skills, especially Word
• Advanced Excel experience required