Bill Review Team Lead - BRT I

Job Description

Medlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of our Medlogix® technology, our highly skilled staff, access to our premier health care provider networks, and our commitment to keeping our clients’ needs as our top priority. Medlogix has a powerful mix of medical expertise, proven processes and innovative technology that delivers a more efficient, disciplined insurance claims process. The result is lower expenses and increased productivity for the auto insurance and workers’ compensation insurance carriers; third party administrators (TPAs); and government entities we serve.

Job Title: Bill Review Team Lead Level I

Full-Time Remote

General Description:

Manage and oversee the Medical Bill Process Support team, ensuring the efficient handling and routing of documents based on individual client criteria. This role focuses on maintaining compliance with client Service Level Agreements (SLAs) while driving team performance to meet key metrics. By combining leadership, workflow coordination, quality assurance, and process improvement, the lead ensures high standards of accuracy, efficiency, and overall operational excellence.

Key Responsibilities:

• Team Leadership and Supervision:
• Lead and mentor a team responsible for processing and organizing medical bill review documents.
• Develop and communicate roles and responsibilities, ensuring staff alignment with organizational goals.
• Conduct regular team meetings to foster collaboration and address challenges.
• Workflow Management:
• Oversee the flow of incoming documents, ensuring timely and accurate processing while adhering to company policies and client-specific criteria.
• Make decisions regarding document handling based on carrier-specific requirements.
• Document Review Oversight:
• Monitor and ensure the accurate categorization, review, and handling of documents.
• Identify and flag discrepancies or incomplete documents for resolution.
• Training and Development:
• Develop and maintain Standard Operating Procedures (SOPs).
• Provide ongoing training and support to team members to enhance their skills and performance.
• Performance Monitoring and Quality Assurance:
• Set performance goals and track team progress in efficiency, accuracy, and turnaround times.
• Perform random sampling of reviewed documents to ensure quality standards are met.
• Conduct regular trend analyses to identify areas for improvement in staff performance and processes.
• Reporting and Communication:
• Prepare and deliver regular reports to management, highlighting team performance, accomplishments, and opportunities for improvement.
• Share monthly department statistics and observations to support strategic decision-making.
• Process Improvement:
• Analyze trends and recommend system and process enhancements to improve workflow efficiency and document handling accuracy.
• Additional Duties:
• Ensure flexibility and adaptability in managing other assigned tasks.
• Travel as required to meet business needs.
  

Qualifications:

• Proven experience in document workflow management or a related field.
• Strong leadership and team management skills.
• Exceptional organizational and decision-making abilities.
• Proficiency in analyzing trends and implementing process improvements.
• Familiarity with carrier-specific criteria and compliance requirements.
• Excellent communication and reporting skills.
• Ability to travel, if needed.
  
  

Preferred Skills:

• Experience in medical billing or claims processing.
• Advanced proficiency in workflow management tools and systems.
• Knowledge of SOP development and quality assurance practices.
  
  

Work Experience Requirements:

Required:

• Excellent written and verbal communication skills
• Strong analytical skills; detail oriented, the ability to think big picture/strategically
• Quick learner: help manage change
• Process and task oriented, ability to manage multiple workflow processes
• Medical coding experience - CPT, ICD knowledge a plus
• Strong leadership skills; minimum 2 years leadership experience
• Computer savvy and previous experience using Microsoft Office Products
  
  

Preferred:

• Minimum 2 years medical billing or claims processing background
• Minimum 2 years Auto Claim Management experience
• Previous experience managing an automated process with exception handling
  
  

Education:

Bachelor’s Degree or Equivalent experience

EEOC STATEMENT:

Medlogix is an Equal Opportunity Employer. Medlogix does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, disability, national origin, veteran status or any other basis covered by appropriate law. We will continue to maintain our commitment to making all employment-related decisions based on the merit of each individual.