Lead, Coding & Billing

With 150+ locations in 17 states, QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S. At QualDerm Partners, we are united in our purpose: to educate, protect, and care for your skin. We are committed to bringing you the very best in comprehensive skin care so that you can achieve a confident, healthier, and more beautiful you! Our mission is to educate communities and healthcare professionals about the importance of skin health; including skin cancer prevention, risk factors and how to achieve healthy skin through annual skin exams and dermatologic care. We strive to provide the latest proven, proactive and comprehensive dermatologic care to populations in the expanding geographies we serve by making high-quality skin care timelier and more accessible all while creating a rewarding work environment for our providers and employees.

Position Summary

This position works with a professional team of physicians and other staff who are trained in the medical and surgical specialty of dermatology with the purpose to be patient focused with the objective of delivering superior patient care and ensuring a positive patient experience and outcome.

The Coding and Billing Team Lead is responsible for the billing/coding needs of all QualDerm Partners practices and providers, as assigned. This position reports to the Revenue Cycle Manager and/or Director of Revenue Cycle.

Essential Responsibilities

• Review and audits medical records for correct CPT, ICD-10, and HCPCS codes for multiple providers in each practice throughout the Company and make corrections as necessary.
• Manage claims returned which have failed scrub rules.
• Monitor Payer Par daily.
• Monitor missing charges daily and communicate with providers, lead and managers as needed.
• Assists with pre and post audits while maintaining compliance with payer reimbursement policies and government regulations as well as Medicare/CMS guidelines.
• Analyze code, interpret and compile medical information/records to document patient condition and treatment.
• Code, prepare and submit clean claims to insurance companies via electronic and paper submissions.
• Keep Billing-Coding Team Lead informed as necessary related to coding/billing/documentation
• Maintains required CEUs.
• Work with management and staff to ensure the front desk is an integral part of billing/collection process.
• Provide training for new employees.
• Assist with inbound calls from patients, providers and other staff members
• Communicates with team members in a courteous, professional, cooperative, and mature manner.
• Treats staff, physicians, visitors and patients with dignity and respect.
• Adheres to Code of Conduct and Mission & …