Hospital Biller

Hospital Billing Supervisor

Hybrid option Locations either Montvale, Woodmere NY or Lakewood NJ.

Our client is seeking a Hospital billing supervisor. The Hospital Billing Supervisor is responsible for the day-to-day oversight of hospital billing operations, ensuring accurate and timely claim submission across all payer types, including Medicare, Medicaid, Managed Care, and Commercial Insurance. This role supervises billing staff, manages workflow queues, resolves escalated issues, and ensures compliance with all regulatory and payer requirements. The Supervisor plays a key role in driving productivity, reducing billing errors, and supporting overall revenue cycle performance.

Responsibilities:

Team Supervision & Productivity Management

• Supervise daily activities of billing staff, including:
• Work queue assignments
• Productivity tracking
• Quality assurance reviews
• Establish and monitor individual and team KPIs
• Provide ongoing training, coaching, and performance feedback
• Assist in onboarding and training new billing staff

Billing Operations

• Oversee daily billing functions, including:
• Inpatient and outpatient claim billing (UB-04)
• Claim edits and scrubber work queues
• Charge reconciliation and late charges
• Ensure claims are submitted timely and accurately per payer guidelines
• Monitor and resolve claim holds, rejections, and front-end edits

Quality Assurance & Compliance

• Conduct routine audits of claims to ensure:
• Accuracy of billing data
• Compliance with CMS and payer-specific requirements
• Ensure adherence to:
• Medicare and Medicaid billing rules
• HIPAA regulations
• Internal compliance policies
• Identify and correct trends in billing errors

Denials & Issue Escalation

• Serve as first-level escalation point for billing-related issues
• Work closely with AR/Collections teams on denial trends
• Assist in root cause analysis and implementation of corrective actions
• Review and resolve complex or high-dollar claims

Revenue Cycle Performance

• Monitor key metrics, including:
• Billing lag (Discharge to Bill)
• Clean claim rate
• Initial rejection rate
• Ensure timely movement of accounts through billing workflows
• Support initiatives to improve cash flow and reduce AR days

Systems & Reporting

• Utilize billing systems (e.g., Epic, Cerner, Meditech) to:
• Monitor work queues
• Run productivity and error reports
• Assist with system testing, updates, and workflow improvements
• Maintain reporting logs and dashboards for leadership review

Cross-Department Collaboration

• Coordinate with:
• Coding (for claim accuracy and DRG/APC issues)
• Patient Access (insurance verification, authorizations)
• Finance (billing reconciliation and reporting)
• Communicate billing issues impacting reimbursement

Qualifications:

Education:

• Associate's or Bachelor's degree in Healthcare Administration, Business, or related field preferred

Experience:

• 3–5+ years of hospital billing experience

• Prior supervisory or lead experience preferred

• Strong knowledge of:

o UB-04 billing

o Medicare/Medicaid reimbursement

o Managed Care billing requirements

Certifications (Preferred)

• HFMA (CRCR)

• AAHAM (CPAT, CRCS)

Key Skills & Competencies

• Strong leadership and team management skills

• Detail-oriented with high accuracy standards

• Ability to manage high-volume workflows and deadlines

• Analytical mindset with problem-solving capabilities

• Strong communication and organizational skills

Key Performance Indicators (KPIs)

• Claims billed per day per FTE

• Clean claim rate (%)

• Billing lag (Discharge to Bill)

• Initial rejection rate (%)

• Error rate from QA audits

• Work queue aging

Work Environment

• Hospital or centralized billing office setting (on-site or hybrid)

• Fast-paced, deadline-driven environment

Compensation (Optional Section)

• Base salary with potential performance-based incentives tied to billing accuracy and productivity