Position Summary: The Lead, Billing plays a pivotal role in overseeing the billing operations,  ensuring accurate and timely processing of patient invoices, and optimizing revenue cycle  management practices.

This position is responsible for driving revenue performance, ensuring compliance with healthcare  regulations, and leading a team to support the hospital’s financial health. It requires strong leadership  and strategic planning to achieve operational efficiency and maintain high levels of patient satisfaction.

Core Working Relationships/Key Stakeholders 

Internal on-site 

• Clinical Staff, Medical Records Department, Front Desk Staff, Finance and Accounting Team,  Management, All Department Heads

External

• Patients, Insurance Providers, Regulatory Authorities, Locum Surgeons, Third-Party  Companies.

Accountabilities: 

Shall work with and under the supervision of the Group Head, Billing, Transaction Services, and  Settlement.

Key Responsibilities 

• Lead and manage the billing team, fostering collaboration and accountability. • Assign responsibilities, set performance targets, and conduct regular evaluations. • Provide training to team members to enhance their skills and knowledge.
• Oversee the preparation and submission of patient invoices, ensuring accuracy and timeliness. • Supervise the submission of insurance claims, monitoring for prompt reimbursement.
• Ensure that billing procedures align with the hospital’s financial goals and compliance  standards.
• Optimize the hospital’s revenue cycle by reducing claim denials and identifying areas for  improvement.
• Monitor key performance indicators (KPIs) such as accounts receivable aging and denial rates,  and implement corrective actions to maximize revenue.
• Collaborate with clinical and finance departments to ensure proper coding and  documentation for billing.
• Conduct regular audits of billing records to ensure compliance with regulations and minimize  errors.
• Stay informed of the latest healthcare billing regulations and implement necessary  adjustments to ensure compliance.
• Ensure that patient information and billing records are secure and confidential, adhering to all  legal requirements.
• Identify and implement process improvements to streamline billing operations and enhance  accuracy.
• Leverage technology to automate billing workflows and increase productivity. • Monitor trends in billing practices and recommend strategies for continuous improvement. • Address patient inquiries and concerns regarding billing with professionalism and empathy.
• Ensure that the billing team provides clear and accurate information to patients about their  bills, insurance claims, and payment options.
• Foster positive relationships with insurance companies to ensure efficient claims processing  and dispute resolution.

Qualifications and Competencies 

• HND/Bachelor’s degree in Social Sciences, Accounting, or a related field (preferred). • Additional certification in healthcare billing or revenue cycle management is an asset.

Experience 

• Minimum of 5 years of experience in healthcare billing, revenue cycle management, or  healthcare finance.
• At least 2 years of experience in a leadership or supervisory role.
• Experience with healthcare billing software and Electronic Medical Records (EMR) systems.

Key Skills 

• Strong leadership and team management skills.
• Proficiency in healthcare billing processes, insurance claim management, and regulatory  compliance.
• Analytical skills for revenue cycle optimization and problem-solving.
• Excellent communication and interpersonal skills, with the ability to handle patient inquiries  professionally.
• Attention to detail and the ability to manage multiple tasks effectively.

Personal Qualities 

• Dependable and responsible in overseeing billing operations and team performance. • Strong commitment to patient confidentiality and data security.
• Ability to remain calm and focused under pressure, especially when dealing with complex  billing issues.
• Willingness to embrace continuous learning and stay updated on industry trends and  regulatory changes.