Insurance​/Rcm Supervisor

The Insurance & RCM Supervisor is responsible for overseeing the complete medical insurance and revenue cycle processes ensuring efficient claim submission timely reimbursements accurate patient billing and compliance with regulatory and payer requirements. This role acts as the bridge between clinical billing and finance teams to optimize revenue flow and minimize denials.

Key Responsibilities:

Insurance Management:

• Supervise pre-authorization eligibility verification and claims submission processes.
• Ensure accurate documentation coding (ICD-10 CPT) and adherence to payer guidelines.
• Monitor insurance claims status and follow up on delayed or denied claims to ensure maximum reimbursement.
• Coordinate with insurance companies and TPAs to resolve complex insurance queries or disputes.
• Maintain up-to-date knowledge of insurance policy changes and communicate them to relevant teams.

Revenue Cycle Management:

• Oversee all stages of the revenue cycle from patient registration charge entry and billing to collections and payment posting.
• Analyze revenue cycle metrics (DSO AR aging collection rate) and take corrective actions as needed.
• Implement strategies to reduce claim denials improve cash flow and increase collection efficiency.
• Conduct regular audits to ensure data integrity billing accuracy and regulatory compliance.
• Work with IT finance and clinical departments to streamline processes and improve system performance.

Team Management & Reporting:

• Supervise and train a team of insurance and billing staff ensuring high levels of performance and accountability.
• Generate and present periodic reports on insurance claims revenue cycle KPIs and outstanding receivables.
• Assist in policy development SOP implementation and software system enhancements related to RCM and insurance workflows.

Requirements:

• Bachelors degree in Healthcare Administration Finance Business or a related field.
• 5 years of experience in health insurance and/or revenue cycle management with at least 3 years in a supervisory role.
• Strong understanding of medical billing coding standards and payer policies.
• Proficiency in healthcare information systems (HIS) billing software and Microsoft Excel.
• Excellent communication analytical and leadership skills.