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Billing Supervisor

Pure Infusion

Position Summary The Billing Supervisor is responsible for the day-to-day supervision of billing staff and oversight of claim submission and early follow-up activities for assigned payer lines of business. Each supervisor manages a defined payer portfolio to ensure timely, accurate, and compliant billing, strong clean-claim performance, and effective denial prevention and resolution. Payer Portfolio Assignments Billing Supervisor – Commercial & UHC: Primary responsibility for UnitedHealthcare (all UHC lines of business, including commercial and managed care products). Oversight of all non-government, non-BCBS/Anthem commercial payers, including other national and regional plans, self-funded groups, and related commercial lines of business. Billing Supervisor – Government & BCBS/Anthem: Primary responsibility for all government payers, including Medicare, Medicaid, Medicare Advantage, Medicaid managed care plans, and other government-funded programs. Oversight of all BCBS and Anthem lines of business, including state and national BCBS plans and Anthem-branded products. Key Responsibilities Team Leadership: Supervise, train, and evaluate billing staff performance, including assigning work, monitoring productivity, and providing regular feedback and coaching. Revenue Cycle Management: Monitor accounts receivable (A/R) and oversee timely, accurate submission of claims to all payers, ensuring adherence to payer filing limits and organizational standards. Compliance and Auditing: Ensure compliance with federal, state, and payer‑specific regulations, including HIPAA, and perform regular internal audits of billing activity to identify and correct issues. Denial Management: Analyze claims data and denial trends, resolve complex billing issues, and partner with Denials/Follow‑up and Patient Access teams to reduce preventable denials and billing errors. Reporting: Prepare and distribute monthly financial and statistical reports on billing performance, A/R metrics, denial trends, and clean‑claim rates for management review. Oversee the medical billing process from claim generation through submission and clearinghouse edits, ensuring claims are submitted accurately and within required timeframes. Collaborate with Charge Entry & EDI to identify root causes of recurring billing issues, including coding, modifiers, units, enrollment, and benefit setup, and implement sustainable workflow and system fixes. Assist with payer and internal audits by preparing billing documentation, reports, and responses and ensuring billing practices align with payer contracts and organizational policies. Develop, update, and enforce standard operating procedures and desk‑level workflows for the billing team, emphasizing standardization across sites and payers. Provide subject‑matter expertise and escalation support for complex account issues, coordination of benefits, and multi‑payer scenarios. Participate in or lead special projects related to system upgrades, payer implementations, new site or service go‑lives, and integration of acquired entities into standard billing workflows. Perform other related duties as assigned to support Revenue Cycle and organizational goals. Supervisory Responsibilities Directly supervises a team of Senior Billers. Responsible for hiring, onboarding, training, attendance, performance evaluations, and corrective actions for assigned staff. Helps foster a high‑performing, collaborative culture focused on accuracy, throughput, accountability, and continuous improvement. Required Qualifications Experience: Minimum 5 years of medical billing experience, including at least 2 years in a supervisory or lead role strongly preferred. Technical Knowledge: Expert knowledge of medical billing workflows, including ICD‑10, CPT, HCPCS, modifier application, NDC reporting, and payer adjudication logic. Education: Associate's degree in healthcare administration, Business, or a related field work with equivalent work experience considered. Skills: Strong leadership, analytical, communication, and organizational skills, with the ability to manage multiple priorities and deadlines in a high‑volume environment. Technology & Systems Practice Management: AdvancedMD (preferred) Infusion Workflow / EHR: WeInfuse (preferred), R2 integration Clearinghouse: Waystar (preferred) Payer Portals: UHC Provider Portal, Availity, Navinet, payer‑specific portals as required by assigned portfolio Preferred Qualifications Prior experience in infusion, oncology, specialty pharmacy, or other high‑acuity reimbursement environments. Experience in a centralized business office or multi‑site, multi‑state healthcare environment. Hands‑on Waystar clearinghouse experience, including rejection workflow management, ERA/835 reconciliation, and payer‑specific edit configuration. Experience supporting mergers, acquisition, or TIN consolidation activities — including impact on payer enrollment, claim adjudication, contract assignment, and integration of acquired entities into standardized billing workflows. Certification in medical billing or coding, such as CPC, CCS, CPB, or a revenue cycle‑focused certification (CRCR, CRCP‑I), preferred. Knowledge, Skills, and Abilities Strong understanding of end‑to‑end revenue cycle processes, particularly charge entry, billing, rejections, and early‑stage denials. Ability to interpret payer policies, EOBs, ERAs, and remittance codes and translate them into actionable process improvements. Demonstrated ability to coach and develop staff, balance workloads, and lead through operational change. High attention to detail and accuracy, with strong problem‑solving skills and comfort working with data and reports. Effective verbal and written communication skills to interact with staff, leadership, providers, and external partners. Common Performance Targets Maintain A/R aging within defined departmental and industry benchmarks, including keeping the majority of A/R in target aging buckets and reducing preventable aged receivables. Ensure high billing accuracy, reflected by strong clean‑claim performance and low correction or rework volume. Maximize revenue collections by improving first‑pass payment outcomes, reducing avoidable denials, and supporting timely resolution of outstanding balances. Working Conditions This is a remote/hybrid position. The Billing Supervisor works primarily from a home office with periodic on‑site presence at the corporate office or clinic locations as needed for team meetings, audits, system implementations, or payer working sessions. Reliable high‑speed internet, a HIPAA‑compliant homework environment, and the ability to maintain consistent business‑hours availability across the multi‑state footprint (MT/PT time zones primary) are required. Prolonged periods working at a computer, participating in virtual meetings, and managing staff through electronic systems and communication platforms should be expected. Benefits 401(k) Matching Health, Vision, and Dental Insurance Over 20 days of paid time off annually #J-18808-Ljbffr

Vacancy posted 3 days ago
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