Lead Medical Biller

Role Overview: Lead Medical Insurance Biller This position is responsible for submitting medical claims, verifying insurance, following up on unpaid claims, and managing patient accounts to ensure timely and accurate reimbursement. Key duties include accurately coding diagnoses and procedures, processing payments, handling denials and appeals, and communicating with patients and insurance companies. Additionally, this role serves in a lead capacity by training, mentoring, and supporting the billing team while helping identify process improvements and modeling The Mercy Way culture.

What You'll Do: Claim submission: Prepare and submit insurance claims to various payers, including private insurance, government programs, corporate accounts, and special programs. Insurance verification and payments: Verify patient insurance coverage and eligibility; manage patient accounts, payments, and medical collections. Denial and appeal management: Follow up on denied or unpaid claims, research reasons for denial, and submit appeals with appropriate documentation. Patient and provider communication: Answer patient billing questions, explain statements, and work with providers to resolve billing or coding discrepancies. Record maintenance and compliance: Maintain accurate billing records in the EMR/EHR and stay current on ICD-10/CPT coding, payer policies, and relevant regulations (including HIPAA).Leadership and training: Provide training, education, and resources to the billing team, supporting consistency, accuracy, and continuous improvement.

What We're Looking For: High school diploma or equivalent.35 years of experience in medical billing or insurance claims processing, with strong claims management and payer relations skills. Proficiency with medical billing software and EHR systems, and strong knowledge of ICD-10 and CPT codes. Demonstrated ability to train and mentor billing staff, with excellent communication, problem-solving, and organizational skills. Ability to work independently and as part of a team in a fast-paced, mission-driven environment. Join a team where your billing expertise, leadership, and commitment to compassionate service are valued, your growth is supported, and your work truly makes a difference.