Business Office Lead-Biller

Job Summary

The Business Office Lead & Biller is responsible for performing the day-to-day billing functions of the Ambulatory Surgery Center (ASC) while providing direct supervision and oversight of assigned business office staff. This position is responsible for maintaining individual billing responsibilities while coordinating and monitoring key business office functions, including accounts receivable, denial management, insurance verification and authorizations, and scheduling.

Duties and Responsibilities Description

Billing and Revenue Cycle Management

• Personally perform ASC billing functions, including claim review, submission, corrections, and payer follow-up.
• Manage assigned accounts receivable, denials, appeals, and reimbursement discrepancies.
• Monitor outstanding claims and identify opportunities to improve collections and reduce preventable denials.
• Maintain accurate billing documentation and follow applicable payer requirements and established billing procedures.

Insurance Authorizations and Scheduling

• Oversee insurance verification and authorization workflows assigned to business office staff.
• Ensure authorizations and required financial clearance activities are completed accurately and timely.
• Coordinate with scheduling, clinical staff, and physicians' offices to resolve outstanding issues affecting scheduled procedures.
• Monitor authorization-related denials and assist in preventing avoidable delays and reimbursement issues.

Staff Supervision and Accountability

• Directly supervise assigned business office staff and coordinate daily workloads.
• Establish and communicate expectations for accuracy, productivity, timeliness, attendance, and professionalism.
• Monitor staff performance and provide appropriate coaching, guidance, and training.
• Address performance concerns and promote accountability among assigned staff.
• Participate in performance evaluations and performance improvement plans in collaboration with the Business Office Manager.
• Promote teamwork, professionalism, and consistent adherence to established workflows and departmental procedures.

Operational Oversight and Communication

• Balance individual billing responsibilities with oversight of daily business office operations.
• Monitor workflow completion, AR aging, denials, and authorization status.
• Identify operational concerns and recommend process improvements to increase efficiency and productivity.
• Maintain an inventory of business office supplies and equipment and communicate supply needs as appropriate.
• Communicate performance trends, staffing concerns, workflow issues, and unresolved matters to the Business Office Manager.
• Maintain confidentiality and comply with applicable HIPAA requirements, payer regulations, and organizational policies.

Qualifications

• EDUCATION
• High School Diploma required (or equivalent)
• EXPERIENCE
• Previous experience in medical billing is required; ambulatory surgery center experience preferred.
• Previous supervisory or team-lead experience preferred.
• Working knowledge of medical insurance processes, payer requirements, and billing procedures.

Knowledge/skills/abilities

• Demonstrated knowledge of medical billing, claims processing, and revenue cycle management, preferably within an ambulatory surgery center.
• Knowledge of accounts receivable management, denial resolution, appeals, reimbursement processes, and insurance authorization requirements.
• Understanding of insurance verification, scheduling, and financial clearance workflows.
• Ability to supervise staff, coordinate workloads, provide constructive feedback, and maintain accountability.
• Strong organizational, communication, analytical, and problem-solving skills.
• Ability to prioritize competing responsibilities, manage time effectively, and meet established deadlines.
• Ability to maintain accuracy, confidentiality, professionalism, and attention to detail in a fast-paced office environment.

Core Competencies

N/A

Physical Requirements

• Talk / Hear
• Repetitive Use of Hands
• See
• Sit

Hazards and Atmospheric Conditions

• Normal Office Surroundings

Competencies

Agility

• Resourcefulness: Adapts quickly to changing circumstances; cleverly navigates obstacles and constraints.
• Manages Uncertainty: Comfortable when things are in flux; readily shifts approach or behavior to fit changing circumstances.

Bias to Action

• Action Oriented: Propensity to act or decide and move forward with a logical approach; can decide and act without having the total picture.
• Delivering Results: Strives for high levels of achievement; maintains a clear and steady focus on meeting goals, despite obstacles; is resilient when encountering setbacks.

Customer Focus

• Identifying with Customers: Understanding who the external and internal customers are and what they value.

Managing Complexity

• Essence: Extracts the core meaning out of complex situations; can separate the important from the noise when problem solving; hunts for the root cause of successes and failures.

Manages Conflict

• Can hammer out tough agreements and settle disputes equitably.
• Stays positive, constructive, and respectful, even in disagreements or conflicts.