Lead PFS Medical Billing Specialist
Core
Senior-level expertise in professional fee services (PFS) medical billing, ensuring accurate, compliant, and timely revenue cycle operations while resolving complex account issues.
Role type
Lead PFS Medical Billing Specialist (Senior IC with mentoring)
Builds
Revenue cycle operations, compliant claim submissions, and departmental billing practices
Domain
Healthcare / Medical Billing / Revenue Cycle Management
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
PFS medical billing, revenue cycle operations, complex claim error resolution, payer requirements knowledge, state/federal healthcare compliance, staff mentoring, onboarding coordination, root cause analysis, payer policy research, reconciliation, reporting, audit support
Preferred skills
Leadership support, process improvement, cross-functional collaboration, special project management
Technologies
None stated
Responsibilities
Serve as a proxy for the department manager and provide leadership support; Coordinate productivity and quality program standards; Act as a subject matter expert for complex billing and account issues; Monitor hospital and clinic compliance with regulations; Plan and implement onboarding for new caregivers; Deliver staff training on payer guidelines; Establish and verify billing controls; Mentor Medical Billing Specialists; Analyze and resolve accounts with revenue cycle teams; Complete month-end reconciliation reports; Submit claims meeting payer requirements; Research payer issues and resolve denials; Support audits and reporting initiatives
Seniority
Senior, hands-on IC with mentoring