Healthcare Billing Operations Lead

Job post summary

Pay: $52,000.00 per year

Job description:

Job Title:

Billing Supervisor

Reporting To: CEO/HR

Exempt Position

Overview
Join our dynamic team as a Billing Supervisor and lead our billing operations with energy, precision, and a passion for excellence! In this pivotal role, you will oversee the entire billing process, ensuring accuracy, timeliness, and compliance across all accounts. Your leadership will drive efficiency, foster teamwork, and uphold the highest standards of financial integrity. This is an exciting opportunity for a motivated professional eager to make a significant impact in a fast-paced environment while supporting the financial health of the organization.

Position Overview

The Billing Supervisor is responsible for overseeing the daily operations of the medical billing department, ensuring accurate claim submission, timely reimbursements, and compliance with federal, state, and payer regulations. This position supervises billing staff, monitors revenue cycle performance, and ensures adherence to proper coding, prior authorization requirements, and referral protocols.

The ideal candidate will have at least seven (7) years of experience in healthcare billing, including demonstrated supervisory experience, and strong knowledge of medical coding, payer requirements, prior authorizations, and referral management. The Billing Supervisor plays a critical role in maintaining revenue integrity and optimizing the organization’s reimbursement processes.

Key Responsibilities

• Revenue Cycle Oversight
• Supervise the day-to-day operations of the billing department, including claim submission, payment posting, denial management, and accounts receivable follow-up.
• Monitor billing workflows to ensure claims are submitted accurately and within payer deadlines.
• Ensure compliance with payer policies, federal regulations, and internal billing procedures.
• Review billing reports and key performance indicators to maintain optimal revenue cycle performance.

Prior Authorizations & Referral Management

• Oversee the verification, documentation, and tracking of prior authorizations required by commercial payers, Medicare, and Medicaid plans.
• Ensure services rendered align with approved authorizations and payer requirements.
• Supervise staff responsible for obtaining and documenting referrals and authorizations prior to service delivery.
• Identify and resolve authorization-related claim denials or delays in reimbursement.
• Maintain updated knowledge of payer-specific authorization and referral requirements.

Coding Compliance & Accuracy

• Ensure accurate application of CPT, HCPCS, and ICD-10 codes for services rendered.
• Review billing practices to ensure coding compliance with payer guidelines and regulatory standards.
• Collaborate with providers and clinical staff to resolve coding discrepancies or documentation gaps.
• Provide guidance to billing staff regarding coding updates and reimbursement policies.

Staff Supervision & Leadership

• Supervise and support billing personnel, including billers, authorization specialists, and accounts receivable staff.
• Delegate tasks effectively and ensure workloads are balanced across the team.
• Provide coaching, training, and performance evaluations to department staff.
• Foster a collaborative work environment that promotes accountability and operational efficiency.

Denials & Accounts Receivable Management

• Monitor and reduce claim denials through proactive review of billing practices.
• Identify trends in payer denials related to coding, prior authorizations, or referrals.
• Ensure timely appeals and resolution of denied or underpaid claims.
• Maintain oversight of accounts receivable aging and implement strategies to improve collections.

Reporting & Compliance

• Generate and analyze billing performance reports, including:
• Clean claim rates
• First-pass acceptance rates
• Accounts receivable aging
• Denial trends
• Ensure adherence to HIPAA regulations and patient confidentiality standards.
• Assist leadership with revenue cycle strategy and operational improvements.

Qualifications

• Required Experience
• Minimum of 7 years of healthcare billing experience
• At least 2–3 years of supervisory or team leadership experience
• Demonstrated…