RCM Medical Billing Operations Supervisor

Jobtailor; Deutschland; Vor Ort; EUR 70.193 - 96.516; Vollzeit

Zusammenfassung

Jobtailor is seeking an Experienced RCM Medical Billing Operations Supervisor to lead the front end of the billing cycle and supervise a small team of billing professionals. You will ensure timely claim submission, accurate coding, and proactive problem solving across payer rules and EHR mappings.

The role requires five years of billing/coding experience, strong Excel skills, and excellent communication. This is a full-time position with emphasis on process improvement and audits.

Qualifikationen

• Associate or bachelor’s degree in Medical Billing and Coding, Health Information Management, Healthcare Administration or related field preferred.
• Minimum of five (5) years of experience in medical billing and coding, preferably in nonprofit healthcare or behavioral health.
• Experience with claims clearinghouses, 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 forms, plus payer-specific reimbursement requirements and regulations.
• Proficiency in Microsoft Excel (sorting, filtering, formulas, pivot tables, data analysis).
• Excellent communication skills with staff, leadership, payers, and external stakeholders.
• Reliable attendance and dependability.

Aufgaben

• Oversee the front end of the medical billing cycle, including timely and accurate claim submission processes.
• Supervise Coding and Claim Review Specialists and Medical Billing Assistant.
• Ensure resolution of failed claims in the EHR to promote timely submission and reimbursement.
• Monitor unbilled claims and upfront rejections.
• Code and map in the EHR, maintain payer information, billing configurations, fee matrices, and rules for the claim engine.
• Perform RCM Billing Audits and assist in running reports to track department goals.

Kenntnisse

Medical Billing

Medical Coding

Team Leadership

EHR Systems

Claims Clearinghouses

ICD-10-CM Knowledge

CPT/HCPCS

Microsoft Excel

Data Analysis

Communication

Ausbildung

Associate or bachelor’s degree in Medical Billing and Coding

Health Information Management

Healthcare Administration

Tools

Billing Systems

EHR Systems

Claims Clearinghouses

Jobbeschreibung

Responsibilities

• The RCM Medical Billing Operations Supervisor position works under the supervision of the RCM Manager.
• Oversees the front end of the medical billing cycle, namely timely and accurate claim submission processes.
• Supervises the Coding and Claim Review Specialists and Medical Billing Assistant.
• Ensures acceptable resolution of failed claims in the EHR to promote timely submission of claims.
• Monitors unbilled claims and upfront rejections.
• Responsible for coding and mapping in the EHR, maintaining payer information, billing configurations, fee matrices, and rules for the claim engine.
• Performs RCM Billing Audits and may assist in running regular reports to track department goals and progress.
• 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.

Requirements

• 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.
• Reliable attendance and dependability, with a demonstrated commitment to meeting job responsibilities and organizational expectations.

Core Competencies

Demonstrates expertise in medical billing and coding processes, including claim submission, coding compliance, and payer regulations. Proficient in managing billing operations, conducting audits, and resolving complex claim issues to ensure timely reimbursement.

Highest-signal resume keywords

• Medical Billing And Coding
• Claims Management
• ICD-10-CM Knowledge
• Electronic Claim Transactions
• Microsoft Excel Proficiency

Hard Skills

• Claim Submission Processes
• Coding And Mapping
• Billing Audits
• Payer Information Management
• Claim Processing Issues Resolution
• Data Analysis
• Healthcare Billing Standards
• Payer-Specific Reimbursement Requirements
• Performance Evaluations
• Trend Identification

Soft Skills

• Analytical Thinking
• Problem-Solving
• Communication Skills
• Attention To Detail
• Leadership

Industry Keywords

• Healthcare Administration
• Medicare
• Medicaid
• Managed Care Billing
• Washington State Provider One Eligibility

Tools & Technologies

• EHR Systems
• Claims Clearinghouses
• Billing Systems