Job Title: Jr. Medical Billing Lead
Reports to: National Billing Manager
Supervises: Billing Specialists assigned to portfolio

The Jr. Medical Billing Lead owns the financial performance, claim quality, and client relationships for an assigned portfolio of medical billing clients. This role manages a smaller portfolio than the Senior Regional Medical Billing Leads while maintaining established performance standards within the assigned portfolio. The Jr. Medical Billing Lead also provides day-to-day direction and support to Billing Specialists assigned to those accounts and helps maintain service levels as new client volume grows.

• Own collections performance for the assigned client portfolio, including underpayments and appeals.
• Work aged A/R based on revenue impact, prioritizing high-dollar balances and accounts at risk of timely filing.
• Identify revenue leakage from missed charges, underpayments, and payer contract variances.
• Escalate contract-level issues to the National Billing Manager.
• Review payment posting and adjustment accuracy for assigned accounts.

• Drive first-pass claim acceptance through front-end edits, payer rule maintenance, and scrubber configuration.
• Categorize denials by root cause and implement corrective action at the source rather than reworking claims individually.
• Maintain compliance with payer requirements, coding standards, and applicable billing regulations for assigned accounts.
• Escalate systemic compliance risks and high-dollar exposure to the National Billing Manager without delay.

• Absorb newly onboarded accounts and bring them to steady-state billing performance.
• Coordinate with implementation, credentialing, and coding teams to configure billing workflows for new accounts.
• Validate payer setup, fee schedules, and claim configuration before first submission and go-live.
• Document account-specific billing requirements and maintain accurate client records.

• Audit a monthly sample of Billing Specialist work for accuracy and adherence to billing standards.
• Provide day-to-day direction, training, and workflow support to assigned Billing Specialists.
• Address performance gaps directly and escalate unresolved issues to the National Billing Manager.
• Support onboarding and cross-training of new billing staff.

• Lead scheduled client meetings for assigned accounts, with National Billing Manager support during initial account transitions and for escalated or at-risk accounts.
• Deliver monthly performance reporting covering collections, denials, and A/R, including commentary on variances and corrective actions.
• Resolve billing disputes with clients and payers promptly and document resolutions.
• Escalate at-risk accounts to the National Billing Manager as soon as risk is identified.

• Bachelor’s degree in Accounting, Finance, Healthcare Administration, or a related field, or equivalent medical billing experience.

• Minimum of three years of experience in medical billing or revenue cycle, including direct ownership of client accounts and A/R follow-up.
• Working knowledge of CPT, ICD-10, and HCPCS coding.
• Knowledge of payer adjudication rules, denial management, and applicable billing regulations.
• Demonstrated ability to guide, train, and hold accountable a remote or geographically dispersed team.
• Proficiency with billing software, clearinghouse platforms, and financial reporting tools.
• Ability to interpret A/R aging, denial, and collections data and take appropriate action based on findings.
• Ability to work independently and manage competing priorities across multiple client accounts.

Revenue Cycle Knowledge: Understands the full revenue cycle from charge capture through payment posting and appeals, including how decisions at each stage affect downstream collections.

Operations Knowledge: Demonstrates a thorough understanding of operational procedures and their impact on other departments. Acts as an expert resource for others.

Compliance Knowledge: Demonstrates extensive understanding of general and department-specific regulations, including payer requirements and coding standards. Serves as a compliance resource for the team.

Analytical Judgment: Interprets billing data to distinguish isolated errors from systemic issues and prioritizes work based on revenue impact rather than volume.

Client Management: Maintains professional communication and positive client relationships. Communicates performance results and unfavorable information candidly and without delay.

Team Development: Builds morale and fosters collaboration toward shared objectives. Provides direct, specific feedback and holds staff accountable to defined standards.

Computer Skills: Demonstrates a strong understanding of technology used in billing operations and consistently identifies opportunities to improve efficiency through technology.

The physical demands described below are representative of those required to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Physical Strength: Ability to stand and/or sit for periods of time. May be required to walk, reach, lift, carry, and bend. Must be able to lift and/or move up to 10 lbs. and occasionally more than 10 lbs.
• Finger Dexterity: Ability to perform small movements with the fingers, including typing, handling small objects, and similar activities.
• Talking: Ability to accurately convey information verbally to clients and other employees.
• Hearing: Ability to hear average or normal conversations and receive ordinary information.
• Visual Abilities: Requires close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus.

Employer reserves the right to change this job description at any time should business needs arise.