Medical Billing & Coding Team Lead for Physical Therapy Practice

Medical Billing & Coding Team Lead for Physical Therapy Practice Full-Time | Remote Schedule: Monday–Thursday Hours: 8:00 AM–5:00 PM CST / approximately 40 hours per week Compensation: $ 5.00 to $ 6.00 per hour, depending on experience Our client is a specialized physical therapy practice focused on pelvic floor and abdominal health for women . The practice provides compassionate, personalized, one-on-one care using advanced clinical expertise and a holistic, evidence-based approach. The team supports patients experiencing pelvic pain, urinary incontinence, bowel dysfunction, pregnancy and postpartum concerns, diastasis recti, pelvic organ prolapse, core dysfunction, and other pelvic health conditions. Each treatment plan is individualized to help patients restore function, improve confidence, and return to the activities they enjoy. Role Overview We are seeking an experienced Medical Billing & Coding Team Lead to take ownership of critical revenue cycle functions while providing leadership, workflow oversight, and secondary office management support. This is a senior-level position and is not intended for entry-level candidates. The ideal candidate has substantial hands-on experience in U.S. medical billing and coding and can independently manage claims, coding, insurance verification, authorizations, denials, appeals, reimbursement follow-up, and patient financial communication. Because this is a Team Lead role within a small practice, we are looking for someone who can go beyond processing assigned billing tasks. The successful candidate should be comfortable taking ownership of billing operations, identifying issues before they affect revenue, supporting other team members, improving workflows, and serving as a reliable escalation point for billing and operational concerns. Experience in outpatient physical therapy billing and coding is strongly preferred. Key Responsibilities Medical Billing & Coding Review clinical documentation and accurately code outpatient physical therapy services using ICD-10 and applicable billing/coding standards. Ensure coding is supported by clinical documentation and complies with payer and regulatory requirements. Review claims for accuracy and completeness before submission. Submit clean claims promptly, with a strong emphasis on same-day claim submission when documentation is available. Identify documentation or coding deficiencies and coordinate with clinicians to obtain necessary clarification. Maintain a high level of billing accuracy to minimize preventable rejections, denials, and reimbursement delays. Revenue Cycle Management Take ownership of the billing cycle from claim preparation and submission through reimbursement and account resolution. Monitor outstanding claims and proactively follow up with insurance carriers. Track reimbursements and identify unpaid, underpaid, rejected, or incorrectly processed claims. Investigate and resolve billing discrepancies. Manage claim denials, corrections, reconsiderations, and appeals. Analyze recurring denial patterns and recommend process improvements to prevent future issues. Support payment posting and reconciliation workflows as needed. Follow up on outstanding patient and insurance balances while maintaining accurate account documentation. Maintain organized billing trackers, follow-up queues, and aging reports. Insurance Verification & Prior Authorization Verify patient insurance eligibility and benefits before services when required. Confirm coverage details, deductibles, copays, coinsurance, limitations, visit allowances, and other applicable benefits. Determine whether prior authorization or pre-certification is required for physical therapy services. Obtain, track, and follow up on authorizations. Monitor authorization expiration dates and approved visit limits to help prevent avoidable billing issues. Clearly document insurance verification and authorization information within the practice management system. Medicare & Payer Compliance Maintain working knowledge of Medicare guidelines, commercial payer policies, coding requirements, and reimbursement procedures relevant to outpatient physical therapy. Monitor payer-specific billing requirements and policy changes. Help ensure claims are submitted in accordance with documentation, coding, and reimbursement guidelines. Identify potential compliance or reimbursement concerns and escalate them appropriately. Patient Financial Communication Communicate professionally and compassionately with patients regarding insurance benefits and billing concerns. Clearly explain estimated insurance coverage, deductibles, copays, coinsurance, outstanding balances, and patient financial responsibility. Respond to patient billing inquiries and investigate account concerns. Maintain a patient-centered approach when discussing sensitive financial matters. Insurance, Provider & Clinical Coordination Communicate with insurance companies, Medicare, referring providers, patients, and clinical staff regarding claims, authorizations, documentation, and reimbursement. Work directly with physical therapists and other clinical team members when documentation clarification is necessary. Follow up on missing or incomplete documentation that may delay coding or claim submission. Maintain thorough documentation of payer calls, claim statuses, authorization updates, appeals, and other billing activities. Team Lead & Workflow Oversight Serve as a knowledgeable point person for medical billing and coding operations. Help prioritize billing workloads and ensure time-sensitive tasks are completed promptly. Support team accountability and adherence to established billing workflows. Review billing processes and identify opportunities to improve efficiency, accuracy, and revenue-cycle performance. Assist with troubleshooting complex claims, payer issues, coding questions, and reimbursement concerns. Serve as an escalation point for difficult billing and operational matters. Collaborate closely with existing team members, including Jonalyn and the current senior biller/office manager, to ensure continuity of operations and smooth handoffs. Gradually assume greater ownership of billing and operational responsibilities as the current lead reduces her hours. Office Management & Administrative Support Provide secondary office management support as needed. Assist in coordinating day-to-day operational concerns that affect billing, patient service, or clinical workflows. Help maintain organized processes, task tracking, and accountability across the practice. Support communication between the administrative, billing, and clinical teams. Assist with operational problem-solving and ensure important issues are followed through to resolution. Requirements Required Qualifications Substantial hands-on experience in U.S. medical billing and coding is required. Strong proficiency in ICD-10 coding and applicable medical billing codes. Strong understanding of medical terminology and clinical documentation. Hands-on experience with: Insurance eligibility and benefits verification Prior authorization/pre-certification Medical coding and claim preparation Electronic claim submission Claim status follow-up Payment posting and reimbursement tracking Denial management Appeals and corrected claims Outstanding balance and A/R follow-up Working knowledge of Medicare guidelines and commercial payer requirements. Strong understanding of the healthcare revenue cycle. Experience communicating directly with insurance companies, patients, healthcare providers, and clinical teams. Ability to review documentation critically and recognize information that may affect coding or reimbursement. Experience working with EHR, practice management, and medical billing platforms. Excellent written and verbal English communication skills. Strong organizational and time-management abilities. Exceptional attention to detail and commitment to billing accuracy. Ability to manage multiple priorities and deadlines independently in a remote environment. Demonstrated professionalism, maturity, reliability, accountability, and sound judgment. Ability to take ownership of a critical revenue-cycle function with minimal supervision. Highly Preferred Qualifications Previous outpatient physical therapy billing and coding experience. Familiarity with physical therapy documentation and reimbursement requirements. Previous experience in a Senior Medical Biller, Billing Team Lead, RCM Lead, Billing Supervisor, or similar leadership capacity. Experience training, mentoring, or providing workflow guidance to billing or administrative team members. Medical billing and coding certification or equivalent formal training. Previous experience with Jane App. Systems & Training The practice currently uses Jane App as its EHR and practice management platform. Previous Jane App experience is an advantage but is not required for candidates who have strong billing experience and have successfully worked with comparable EHR/practice management systems. The selected candidate will receive structured training from the current billing and office management lead, who has supported the practice for approximately 10 years . Formal Jane App training will also be arranged as needed. The current lead will remain involved during the transition period to provide oversight, answer questions, transfer institutional knowledge, and ensure the incoming Team Lead is positioned for long-term success. Schedule & Transition Employment Type: Full-Time, Remote Current Workdays: Monday through Thursday Current Schedule: 8:00 AM–5:00 PM CST, with extended hours structured to meet approximately 40 hours per week Compensation: 5.00–6.00 per hour, depending on experience The practice expects the schedule to eventually transition to Monday through Friday as the team expands and another physical therapist is added. This is a planned succession and transition rather than an urgent replacement. The selected candidate may begin approximately two months before the current billing lead reduces her hours , allowing sufficient overlap for training, workflow familiarization, and a smooth transfer of responsibilities. Ideal Candidate We are looking for a seasoned Medical Billing & Coding professional and emerging operational leader who can confidently take ownership of the practice's revenue cycle. The ideal candidate does not simply wait for billing tasks to be assigned. They proactively monitor claims, investigate reimbursement issues, recognize potential problems, follow through until resolution, and keep the appropriate team members informed. You should be comfortable working independently while also collaborating closely with clinicians and administrative staff. You understand that billing accuracy directly affects both the financial health of the practice and the patient's experience. Most importantly, we value e xperience, dependability, ownership, sound judgment, attention to detail, and long-term commitment over simply finding the fastest available candidate. Basic Requirements Must speak and write English clearly and professionally. Must have relevant work experience. Must be able to provide an NBI Clearance and/or Local Police Clearance before onboarding (mandatory). Must be available to attend video meetings with camera on when required. Technical Requirements Computer: Reliable laptop or desktop computer. Internet: Stable high-speed internet connection (minimum 25 Mbps). Audio: Noise-canceling headset. Video: Working webcam for virtual meetings. Workspace: Quiet and professional work environment. Benefits Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication. Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks. HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients. Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention. Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule. Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client. Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best. Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance. These are optional resources and client-approved allowances available to you as an independent contractor. Any resources, training, or allowances listed are optional contractor perks and not employee benefits.