Medical Billing Lead

Emerge Pediatric Therapy 

Who are we?

Emerge Pediatric Therapy is a leader in Occupational, Speech and Physical Therapy. We are a woman owned, small business who has been serving the Triangle Area for over 20 years. 

What do we do?

Emerge Pediatric Therapy provides therapeutic services to support the children and their families in our community. We empower caregivers to help their children develop into confident children. We also support our therapists. We want to see our therapists grow in their careers.

Where are we going?

We have grown our practice to better serve more of the Triangle and surrounding areas. Since 2020, we have opened two additional locations to now include, Cary, Carrboro and Durham.  Emerge Pediatric Therapy is a growth-driven practice. Our future goals include continuing to expand our team, to further develop our teams’ specialty skills, and to become the #1 sought-after pediatric clinic for both our clients and employees.

Why should you join us?

Be taken care of…

• We love a good celebration

• Milestone celebrations

• Staff social events

• Coffee and treat days

The Billing Lead will assist the Billing Manager and support the management of billing and collections processes for our outpatient pediatric therapy practice. The role requires strong leadership skills, a comprehensive understanding of medical billing and coding, and a commitment to ensuring accurate and timely claim submissions as well as effective revenue cycle management. The Billing Lead ensures the completion of delegated billing and collections tasks efficiently and accurately.

Responsibilities

Team Leadership

• Supervise and manage team tasks to maintain efficient workflow.

• Provide training, support, and mentorship for team members.

• Monitor team performance to identify and address areas for improvement.

• Perform all other tasks delegated by the Billing Manager after receiving the proper training.

Eligibility, Billing, and Coding

• Conduct insurance eligibility verifications for clients before services are rendered.

• Ensure accurate and timely coding of medical services using CPT, ICD-10, and HCPCS codes.

• Post explanation of benefits (EOB) payments into the electronic healthcare record (EHR) system; including inputting manual checks, downloading and posting manual checks, and reviewing all postings to ensure accurate allocations.

• Stay current on billing and coding regulations and guidelines.

• Identify and resolve coding and billing errors.

Claims Submission and Follow-up

• Ensure the timely submission of clean claims to insurance payers.

• Monitor and research claim statuses and initiate follow-up on denials or rejections.

• Accurately record EBO details in the electronic healthcare record (EHR) system.

• Appeal denied claims as necessary to maximize reimbursement.

• Collaborate with insurance payers to resolve billing issues.

• Coordinate and follow up with internal operations (clinical and office staff) to assist in billing matters.

Revenue Cycle Management

• Report on assigned key performance indicators (KPIs) to identify trends and opportunities for improvement.

• Collaborate with internal operations (front desk and clinical staff) to ensure accurate and complete patient information.

• Develop and maintain strong relationships with insurance payers.

Compliance and Regulatory

• Ensure compliance with HIPAA regulations and other relevant healthcare laws

• Stay informed of healthcare regulations changes and implement necessary updates.

• Maintain accurate and organized records.

• Accurately documents and maintains client files in company EHR and payer online systems

Education

• High School diploma or equivalent

• Have a minimum of 5 years in medical billing and coding.

• Knowledge of NC Medicaid and Managed Care

• Possess familiarity with NC Medicaid, Medicaid Managed Care, and Tailored Health plans, including reimbursement guidelines.

• Demonstrate strong leadership, organizational, and analytical skills.

• Exhibit effective communication, interpersonal, and problem-solving skills.

• Are proficient in medical billing software and electronic health records (EHR) systems.

• Maintain high attention to detail and accuracy with the ability to prioritize tasks.

• Work independently and as part of a team.

• Show a high degree of professionalism, accountability, and ownership.

• Have a willingness to learn, develop new skills, and adapt to change.

• Are goal-driven with a strong focus on reaching targets.

• Utilize creativity and relationship-building abilities.

• Maintain reliable attendance and punctuality.

• Thrive in a fast-paced, team-oriented environment.

• Have a passion for working with the pediatric population and their families.

Emerge Pediatric Therapy offers competitive compensation, comprehensive benefits and many perks including:

• $20-22 per hour 

• Health Insurance; medical, dental and vision

• IRA Plan with 3% matching

• Professional Development

• Paid Time Off & Paid Holidays

• Work Life Balance & Flexibility

• Additional Perks