Medical Billing Supervisor (Night Shift | Hybrid Set-Up)

The ideal candidate will be a hands-on leader who can troubleshoot complex billing issues, train staff, and drive the team to meet key performance metrics.

Key Responsibilities:

• Team Supervision and Workflow Management:
• Supervise the day-to-day activities of a team of Medical Billers and Claims Specialists.
• Monitor daily workflow from claim generation to payment posting to ensure tasks are completed accurately and on time.
• Distribute and balance workloads among team members to meet departmental goals and deadlines.
• Performance Monitoring and Reporting:
• Track and report on team performance against key metrics, including clean claim rate, denial rate, and accounts receivable (A/R) aging.
• Identify trends and patterns in billing data to proactively address issues and improve processes.
• Escalate complex or systemic billing issues to the Medical Billing Manager with clear, data-backed recommendations.
• Troubleshooting and Denial Resolution:
• Serve as the primary escalation point for the team on complex or difficult-to-resolve billing issues, particularly with Medicaid claims.
• Assist the team with preparing and submitting high-level appeals for denied claims.
• Liaise with Medicaid payer representatives to resolve disputes and clarify billing guidelines.
• Training and Development:
• Train new billing staff on our specific workflows, software, and compliance procedures.
• Provide ongoing training and coaching to the existing team to ensure they are up-to-date on Medicaid policies and best practices.
• Develop and maintain documentation of billing procedures and workflows.
• Quality and Compliance:
• Ensure all billing practices adhere to HIPAA, Medicaid, and other state and federal regulations.
• Monitor changes in Medicaid policies and communicate them effectively to the billing team.
• Support the manager in preparing for and conducting internal and external audits.
• Conduct regular quality assurance audits on claims to identify and correct errors before submission.

Required Qualifications:

• Experience:
• Minimum of 5+ years of experience in medical billing, with at least 1-2 years in a lead or supervisory role.
• Extensive, hands-on experience with Medicaid claims processing is essential.
• Proven ability to manage and motivate a team to achieve performance targets.
• Technical Skills:
• Advanced proficiency with Electronic Health Record (EHR) and practice management systems.
• Strong analytical skills with a high degree of proficiency in data analysis using tools like Microsoft Excel.
• Certifications:
• A professional billing certification (e.g., AAPC's Certified Professional Biller - CPB) is highly preferred.