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Role Description

The Revenue Cycle Management Supervisor oversees all aspects of the billing process to ensure accuracy, efficiency, and compliance. This role is responsible for managing an established team of AR specialists, providing guidance and support, ensuring timely and accurate submission of medical claims to insurance companies, and resolving complex billing issues.

• Ensure timely and accurate transmission of claims
• Monitor and manage AR performance indicators to meet or exceed goals
• Ensures billing operations are performed in an accurate and timely manner
• Provide leadership, guidance, and support to billing staff to ensure productivity and morale
• Evaluates billing processes and procedures and assists management in developing revisions
• Execute process improvement directives to streamline billing procedures and enhance efficiency
• Perform claim status follow up activities utilizing the current Practice management (PM), and clearinghouse systems
• Utilize clinical applications, payer websites and other systems as a research tool to retrieve medical documentation, patient eligibility information, billing guidelines, patient referrals, and hospital or procedure code authorizations to substantiate corrected claims submissions, through written appeals, and coding reviews, etc.
• Establish and maintain effective working relationships with carrier representatives and internal and external clients
• Work with billing vendors to ensure that client requests for information (RFIs) and tasks are completed accurately and timely
• Remain abreast of carrier/payer updates as it relates to Billing and Collections guidelines including claim submissions, claim appeals, grievance procedures and policy changes
• Trains and oversees the personnel involved in billing functions
• Directs assigned tasks and aids as needed
• Reviews work of billing staff to ensure accuracy, resolving inconsistencies as needed
• Assists with performance evaluations
• This is a working position and will need to be able to help in various billing functions

Qualifications

• High School Diploma or equivalent required
• Strong knowledge of the accounts receivables (A/R) process
• Bachelor's Degree in a related field preferred
• At least five years healthcare or insurance billing processing experience required
• At least two years in a supervisory role is preferred
• Knowledge of medical terminology, CPT, ICD-10-CM, HCPC codes, CCI edits and HIPAA regulations
• eClinicalWorks experience is a plus

Requirements

• Proficient in medical terminology, anatomy, and physiology
• Strong knowledge of ICD-10 coding
• Familiarity with medical office procedures and billing practices
• Flexible, Detail Oriented, Customer focus, Team working, Initiative, Problem solving, Organized, Self-motivated
• Adopt the USHV culture of respect, integrity and accountability that contribute to an internal environment of teamwork and promote a positive brand image to our external customers
• Incorporate a leadership mindset to your role
• Comply with USHV procedures, policies, and regulations relevant to your role