Lead Medical Biller
Sisters of Mercy Urgent Care DBA Mercy Urgent Care
Summary
This position is responsible for submitting medical claims, verifying insurance, following up on unpaid claims, and managing patient accounts to ensure timely and accurate reimbursement. Key duties include accurately coding diagnoses and procedures, processing payments, handling denials and appeals, and communicating with patients and insurance companies. Additionally, this role serves in a lead capacity by training, mentoring, and supporting the billing team while helping identify process improvements and modeling The Mercy Way culture.
Job description
Role Overview: Lead Medical Insurance Biller
This position is responsible for submitting medical claims, verifying insurance, following up on unpaid claims, and managing patient accounts to ensure timely and accurate reimbursement. Key duties include accurately coding diagnoses and procedures, processing payments, handling denials and appeals, and communicating with patients and insurance companies. Additionally, this role serves in a lead capacity by training, mentoring, and supporting the billing team while helping identify process improvements and modeling The Mercy Way culture.
What You'll Do
- Claim submission: Prepare and submit insurance claims to various payers, including private insurance, government programs, corporate accounts, and special programs.
- Insurance verification and payments: Verify patient insurance coverage and eligibility; manage patient accounts, payments, and medical collections.
- Denial and appeal management: Follow up on denied or unpaid claims, research reasons for denial, and submit appeals with appropriate documentation.
- Patient and provider communication: Answer patient billing questions, explain statements, and work with providers to resolve billing or coding discrepancies.
- Record maintenance and compliance: Maintain accurate billing records in the EMR/EHR and stay current on ICD-10/CPT coding, payer policies, and relevant regulations (including HIPAA).
- Leadership and training: Provide training, education, and resources to the billing team, supporting consistency, accuracy, and continuous improvement.
What We're Looking For
- High school diploma or equivalent.
- 3–5 years of experience in medical billing or insurance claims processing, with strong claims management and payer relations skills.
- Proficiency with medical billing software and EHR systems, and strong knowledge of ICD-10 and CPT codes.
- Demonstrated ability to train and mentor billing staff, with excellent communication, problem-solving, and organizational skills.
- Ability to work independently and as part of a team in a fast-paced, mission-driven environment.
Requirements
- High school diploma or equivalent
- 3–5 years of experience in medical billing or insurance claims processing
- Strong claims management and payer relations skills
- Proficiency with medical billing software and EHR systems
- Strong knowledge of ICD-10 and CPT codes
- Demonstrated ability to train and mentor billing staff
- Excellent communication, problem-solving, and organizational skills
- Ability to work independently and as part of a team
Benefits
- 403(b) Matching
- Medical, Dental & Vision
- Employee Assistance Program
- Volunteer Time Off
- Paid Holidays
- Paid Time Off
- Training & Growth Opportunities
Company overview
Mercy Urgent Care, operating as Sisters of Mercy Urgent Care, is a healthcare provider organization founded in 1985 that operates multiple urgent care centers across Western North Carolina and surrounding regions. As a sponsored ministry of the Sisters of Mercy, the organization provides high-quality, affordable, and convenient medical care for non-life-threatening illnesses and injuries through its network of eight urgent care facilities. The company serves approximately 80,000 patients annually and has treated over one million patients since its inception. Mercy Urgent Care offers comprehensive services including treatment for common illnesses, occupational medicine, pre-employment physicals, DOT physicals, and workplace injury management. The organization maintains a strong commitment to its Mercy mission values, providing care regardless of patients' ability to pay and operating with a focus on community service and compassionate healthcare delivery. With an average wait time of just 16 minutes, the company emphasizes efficient, patient-centered care delivered by licensed medical professionals across its multiple locations.