RCM Medical Billing Operations Supervisor

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. RCM Medical Billing Operations Supervisor 5 days ago Requisition ID: 2002 Salary Range: $21.22 To $24.84 Hourly Work Location: Remote in SW Washington, NW Oregon Responsible To: Revenue Cycle Manager Major Duties The RCM Medical Billing Operations Supervisor position works under the supervision of the RCM Manager. This position oversees the front end of the medical billing cycle, namely timely and accurate claim submission processes and supervises the Coding and Claim Review Specialists, and Medical Billing Assistant. They also ensure acceptable resolution of failed claims in the EHR to promote timely submission of claims and in EPIC Charges/invoices, monitors unbilled claims and upfront rejections. The incumbent is responsible for coding and mapping in the EHR, maintaining payer information, billing configurations, fee matrices, and rules for the claim engine and performs RCM Billing Audits. They may assist in running regular reports to track department goals and progress. In fulfilling these responsibilities, the incumbent performs the following duties: Provides direct supervision to the Coding and Claim Review Specialists and Medical Billing Assistant, meeting regularly to provide guidance, direction, support, and resources necessary for efficient job performance. Conducts quarterly and annual performance evaluations and assists staff in establishing and achieving individual goals aligned with departmental objectives. Troubleshoots, investigates, and resolves failed claims within the claim management system daily to ensure timely claim submission and reimbursement. Configures, maintains, and monitors payer billing settings, procedure code, bill‑next, and adjustment reason code mappings within billing systems. Applies proactive problem‑solving, analytical thinking, and attention to detail to identify, research, and resolve billing, coding, and claim processing issues. Collaborates with clinical staff to identify and resolve documentation‑related issues that impact claim submission, adjudication, and payment. Conducts monthly medical billing and coding audits to ensure compliance with payer requirements, regulatory standards, and organizational policies. Assists in monitoring adherence to established response‑time standards for Patient Customer Service Specialists and related customer service functions. Analyzes workflow trends, unbilled claims, claim inventory, and clearinghouse rejections to identify opportunities for process improvement and revenue optimization. Generates recurring and ad hoc operational and performance reports to monitor key performance indicators (KPIs) and support organizational decision‑making. Provides data‑driven recommendations to improve operational efficiency, billing accuracy, claim outcomes, and revenue cycle performance. Effectively prioritizes competing responsibilities to meet productivity standards, service expectations, and multiple deadlines. Communicates professionally and effectively with team members, clinical staff, leadership, payers, and external stakeholders. Maintains the highest level of confidentiality and complies with all applicable HIPAA, 42 CFR Part 2, and organizational privacy and security requirements. Documents activities, findings, and resolutions in accordance with established policies, procedures, and regulatory requirements, ensuring the integrity and accuracy of all account documentation. Establishes and maintains professional, collaborative, and effective working relationships with colleagues, leadership, and internal customers. Maintains current knowledge of payer requirements, billing and coding regulations, industry standards, and governmental regulations applicable to assigned responsibilities. Functions as an active member of the Revenue Cycle Management team and contributes to the achievement of departmental and organizational goals. Supports, promotes, and implements agency policies, procedures, and strategic initiatives. Performs special projects and other duties related to billing operations, reporting, revenue cycle management, and data analysis as assigned by the supervisor. Knowledge and Skills Required Advanced knowledge of electronic health record (EHR) billing configuration, medical billing, and coding processes, preferably within Qualifacts CareLogic or a comparable behavioral health EHR and billing system. Associate or bachelor's degree in medical Billing and Coding, Health Information Management, Healthcare Administration, or a related field preferred. Minimum of five (5) years of experience in medical billing and coding, preferably within a nonprofit healthcare or behavioral health setting. Demonstrated experience working with claims clearinghouses, including identifying, researching, and resolving claim rejections and edits. Working knowledge of electronic claim transactions, including 837 EDI files and related healthcare billing standards. Comprehensive understanding of commercial insurance, Medicare, Medicaid, and managed care billing requirements, including Washington State Provider One Eligibility. Strong knowledge of ICD-10-CM, CPT, HCPCS, HCFA 1500, and UB-04 claim forms, as well as payer‑specific reimbursement requirements and regulations. Proficient in Microsoft Excel, including the use of sorting, filtering, formulas, conditional formatting, pivot tables, and data analysis functions. Strong analytical and critical‑thinking skills with the ability to identify trends, troubleshoot complex billing issues, and develop effective solutions. Excellent verbal and written communication skills with the ability to communicate clearly and professionally with staff, leadership, payers, and external stakeholders. Demonstrated ability to maintain a high level of accuracy and attention to detail while managing multiple priorities and deadlines. Strong organizational and time‑management skills with the ability to work independently and effectively under pressure. Proven ability to collaborate and maintain positive working relationships across departments and teams. Reliable attendance and dependability, with a demonstrated commitment to meeting job responsibilities and organizational expectations. Guidelines Requires that the incumbent relies on specialized training and/or equivalent experience and performs duties in accordance with Washington Administrative Codes, Federal regulations governing the confidentiality of patient files, and Lifeline Connections Policy and Procedure Manual. Personal Contacts Contacts are with the members of the treatment team, consumers, significant others of the consumers, representatives of various community agencies specializing in the treatment of chemical abuse and mental illness and payers. All personal contacts are carried out in accordance with federal and state laws dealing with the confidentiality of patient records. Physical Demands While performing the essential functions of the job, the employee is regularly required to sit, speak clearly, hear, and use hands and fingers to manipulate writing utensils and keys on a keyboard. Working Environment Working hours are spent indoors in offices or other meeting rooms. Participation in staff retreats and staff development activities will be required. Benefits Lifeline Connections strives to be an employer of choice by offering regular and full‑time employees a robust and highly competitive benefits package designed to support both personal and family well‑being. Our comprehensive benefits include multiple options for medical, dental, and vision coverage for employees and their eligible dependents. In addition, Lifeline Connections provides employer‑paid Short Term Disability, Long Term Disability, and Life Insurance , along with access to supplemental coverage options. Full‑time employees and eligible part‑time employees may also enroll in our 401(k) retirement plan , helping support long‑term financial wellness. Beyond benefits coverage, Lifeline Connections is proud to offer generous paid time off . Both full‑time and part‑time employees earn PTO at competitive accrual rates that increase with years of service , allowing for meaningful time away from work. Employees also receive paid holidays and personal holidays , reinforcing our commitment to work‑life balance and employee well‑being. #J-18808-Ljbffr Lifeline Connections