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Skilled Wound Care

Lead Medical Biller at Skilled Wound Care

Los Angeles, CAFull-timeHealthcare BillingPosted 15 days ago
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About the Role

<h4><strong>Job Description</strong></h4> <p><span style="font-weight: 400;">Skilled Wound Care is looking for a Lead Medical Biller to join our rapidly growing company! We are a mobile surgical physician wound care group expanding into new markets of the United States. T<span class="rnc2Gd" data-ast-node-id="5">he Lead Medical Biller is a critical leader responsible for ensuring the financial health of our organization by overseeing the daily operations of the billing team. This role requires advanced expertise in the end-to-end claims lifecycle, ensuring maximum revenue capture through accurate, compliant, and timely submission of medical claims across all payer types (private, government, and third-party). You will be the primary subject matter expert, driving team performance, resolving complex billing issues, and upholding strict adherence to all federal, state, and FQHC-specific billing regulations.</span></span></p> <p><span style="font-weight: 400;"><span class="rnc2Gd" data-ast-node-id="5">Position is hybrid at our office in Playa Vista, CA</span></span></p> <p><strong>Responsibilities:</strong></p> <ul> <li class="rnc2Gd"><strong><span class="rnc2Gd" data-ast-node-id="8">Supervise &amp; Train:</span></strong><span class="rnc2Gd" data-ast-node-id="9">&nbsp;Lead the training and mentorship of new billing hires, ensuring rapid integration and consistent adherence to best practices.</span><strong><span class="rnc2Gd" data-ast-node-id="10">Quality Assurance:</span></strong><span class="rnc2Gd" data-ast-node-id="11">&nbsp;Assist management by conducting routine audits to ensure compliance with all regulatory and internal billing standards.</span></li> <li class="rnc2Gd"><strong><span class="rnc2Gd" data-ast-node-id="12">Workflow Management:</span></strong><span class="rnc2Gd" data-ast-node-id="13">&nbsp;Partner with management to efficiently re-distribute workloads, optimize team capacity, and maintain productivity.</span></li> <li class="rnc2Gd"><strong><span class="rnc2Gd" data-ast-node-id="16">Issue Resolution:</span></strong><span class="rnc2Gd" data-ast-node-id="17">&nbsp;Proactively identify, report, and collaborate on solutions for problematic issues impacting team duties, efficiency, or compliance.</span></li> <li class="rnc2Gd"><strong><span class="rnc2Gd" data-ast-node-id="21">Claim Submission:</span></strong><span class="rnc2Gd" data-ast-node-id="22">&nbsp;Review, prepare, and verify all claims for accuracy, completeness, and documentation, ensuring they meet specific payer requirements for "clean" submission.</span></li> <li class="rnc2Gd"><strong><span class="rnc2Gd" data-ast-node-id="23">Documentation &amp; Verification:</span></strong><span class="rnc2Gd" data-ast-node-id="24">&nbsp;Verify all billing information, charges, patient documentation, and insurance coverage prior to claim submission.</span></li> <li class="rnc2Gd"><strong><span class="rnc2Gd" data-ast-node-id="25">Follow-Up &amp; Denial Management:</span></strong><span class="rnc2Gd" data-ast-node-id="26">&nbsp;Perform timely and aggressive follow-up on outstanding claims, meticulously resolve denials by correcting errors, gathering necessary documentation, and resubmitting claims efficiently.</span></li> <li class="rnc2Gd"><strong><span class="rnc2Gd" data-ast-node-id="27">Payment Reconciliation:</span></strong><span class="rnc2Gd" data-ast-node-id="28">&nbsp;Analyze and interpret all Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs), confirm accurate payment posting, and manage all necessary claim appeals for underpaid or denied services.</span></li> <li class="rnc2Gd"><strong><span class="rnc2Gd" data-ast-node-id="31">Billing Compliance:</span></strong><span class="rnc2Gd" data-ast-node-id="32">&nbsp;Apply comprehensive working knowledge of governmental billing regulations, including Medicaid, Medicare, and Medi-Cal Managed Care.</span></li> </ul> <p><strong>To learn more information contact us today at (310) 445-5999!&nbsp;</strong></p> <p><span style="font-weight: 400;">Or visit us at </span><a href="http://www.skilledwoundcare.com/"><strong>www.skilledwoundcare.com</strong></a></p> <p><strong>Qualifications:</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">Good verbal and written communication</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">2+ years of Lead Medical Biller experience required</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Medical billing diploma or work experience Lytec or Medisoft experience a plus</span></li> <li class="rnc2Gd"><span class="rnc2Gd" data-ast-node-id="54">Certification as a Certified Professional Coder (CPC) preffered</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Knowledge of Microsoft Office, especially Excel</span></li> <li style="font-weight: 400;"><strong>High School diploma or equivalent is required.</strong></li> </ul> <p><strong>Pay:</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">$25-27/hr Depending on experience</span></li> </ul> <p><strong>Benefits:</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">Health, Dental, Vision Insurance</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Generous 401 K plan</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Paid time off</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Life Insurance</span></li> </ul> <p><span style="font-weight: 400;">&nbsp;</span><strong>Great Place to Work® Certified!</strong></p> <p><strong>Skilled Wound Care</strong><span style="font-weight: 400;"> is proud to be Certified™ by</span><strong> Great Place to Work®</strong><span style="font-weight: 400;"> for the </span><strong>3rd</strong><span style="font-weight: 400;"> year in a row. The prestigious award is based entirely on what current employees say about their experience working at Skilled Wound Care. This year,</span><strong> 95%</strong><span style="font-weight: 400;"> of employees said it’s a great place to work – </span><strong>39%</strong><span style="font-weight: 400;">&nbsp; higher than the average U.S. company.</span></p> <p><span style="font-weight: 400;">Skilled Wound Care will ask all candidates to perform pre-employment confidential DiSC testing and appropriate relevant skills testing prior to hiring.</span></p> <p><span style="font-weight: 400;">Skilled Wound Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age (40 or older), disability or genetic information. Compensation is DOE.</span></p> <p><span style="font-weight: 400;">"SWC1"</span></p>

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