BILLING SUPERVISOR II

NORTH EAST MEDICAL SERVICES; Daly City (CA); On-site; USD 112,247 - 128,752; Full time

Job summary

North East Medical Services is seeking a full-time position in Daly City, CA. The role involves supervising coding practices and provider enrollment in a healthcare setting, ensuring compliance with regulations, and improving front-end processes.

Candidates should possess a four-year degree, relevant certifications, and significant supervisory experience in the healthcare revenue cycle. Proficiency in medical coding and excellent communication skills are essential for success in this role.

Qualifications

• Completion of a four-year degree from an accredited university.
• Must hold at least one Epic Resolute Professional Billing certification.
• Minimum of three years of supervisory experience in a healthcare revenue cycle.
• Five years of professional experience in healthcare revenue cycle operations.
• Working knowledge of coding and enrollment/credentialing processes.
• Strong organizational skills and commitment to customer service.

Responsibilities

• Supervise medical coding function and ensure compliance with regulations.
• Oversee provider enrollment and credentialing processes.
• Conduct evaluations for front-end staff and resolve escalated issues.
• Coordinate with Billing Supervisor to ensure clean hand-offs.
• Design and deliver training on coding, enrollment, and claims software.

Skills

Healthcare revenue cycle operations experience

Medical coding knowledge (ICD-10, CPT, HCPCS)

Leadership and supervisory skills

Excellent analytical and communication skills

Proficient in billing/coding software

Fluent in Chinese (Cantonese and/or Mandarin)

Education

Four-year degree from an accredited university

Epic Resolute Professional Billing certification

Tools

Microsoft Office applications

Epic Professional Billing and Claims

Job description

Job Details

Job Location: Daly City, CA 94014
Position Type: Full Time
Salary Range: $112,247.20 - $128,752.00

ESSENTIAL JOB FUNCTIONS

• Demonstrates a thorough and authoritative understanding of Medicare, Medi-Cal, FQHC (Federally Qualified Health Center), state, local programs, and private insurance regulations, and serves as the front-end subject-matter resource.
• Directly supervises the medical coding function: coordinates and monitors the work of the Medical Coder and Senior Medical Coder, ensures coding and documentation comply with ICD-10, CPT, HCPCS, HCC risk adjustment, and CMS NCD/LCD guidelines, and supports timely resolution of coding‑related and medical‑necessity claim edits.
• Directly supervises the provider enrollment and credentialing function: coordinates and monitors the work of the Provider Enrollment Specialist and Senior Provider Enrollment Specialist, and ensures timely and compliant enrollment, re‑credentialing, revalidation, CAQH attestations, and SB 137 provider‑data maintenance to prevent enrollment‑driven billing disruptions.
• Directs charge review and claim‑edit work: oversees front‑end claim scrubbing, charge capture validation, and resolution of pre‑submission edits to maximize clean‑claim rates.
• Provides direction, monitoring, training, and assistance to front‑end team members; establishes priorities, assigns and balances workloads, inspects completed work, and resolves escalated front‑end issues.
• Conducts probationary and annual evaluations for front‑end staff (coding, provider enrollment, charge/claims); for senior specialist roles, evaluations are completed in consultation with the Revenue Cycle Manager and informed by compliance metrics, productivity data, and technical input from subject‑matter resources.
• Partners with the Billing Supervisor I (Back‑End Revenue) to coordinate clean hand‑offs between front‑end submission and back‑end posting, follow‑up, and AR.
• Uses the Epic Professional Billing and Claims environment for charge, code, and claims‑library awareness, and coordinates with the Epic Analyst (who owns system configuration) to report, validate, and resolve front‑end application issues.
• Monitors front‑end denial trends, identifies root causes, and implements process improvements; develops policies and procedures and ensures consistent adoption across the front‑end functions.
• Designs and delivers training for new and existing front‑end employees on coding, enrollment, charge review, and claims software and workflows.
• Generates and reviews front‑end performance reports (coding accuracy, enrollment status, clean‑claim and edit rates) for the Revenue Cycle Manager and Administration.
• Performs additional duties as assigned by management.

Qualifications

• Completion of a four-year degree from an accredited university.
• Must hold at least one Epic Resolute Professional Billing (PB) certification. Epic Resolute Claims and Remittance certification is preferred.
• Minimum of three years of supervisory experience in a healthcare revenue cycle, billing, coding, or provider enrollment setting, including experience leading or developing staff.
• At least five years of professional experience in healthcare revenue cycle operations in a complex healthcare or FQHC setting, with front‑end (coding, enrollment, charge/claims) exposure.
• Working knowledge of medical coding (ICD-10, CPT, HCPCS, HCC risk adjustment) and provider enrollment / credentialing processes (CAQH, SB 137, payer revalidation) sufficient to supervise these functions; coding credential (AAPC/AHIMA) or equivalent experience preferred.
• Excellent analytical and communication skills, with the ability to convey complex information clearly to technical and non‑technical audiences.
• Proficient in computer skills, including billing/coding software and Microsoft Office applications.
• Ability to write clear and professional business correspondence, policies, and procedures.
• Strong organizational skills, with the ability to manage and coordinate multiple front‑end processes and personnel simultaneously.
• Committed to maintaining high standards of customer service in a demanding and complex healthcare environment.
• Demonstrates initiative, resourcefulness, integrity, and timeliness to achieve high levels of customer satisfaction.
• Self‑motivated, diligent, organized, resourceful, responsible, and enthusiastic in all aspects of work.

Language

• Must be able to fluently speak, read and write English.
• Fluent in Chinese (Cantonese and/or Mandarin) preferred.
• Fluency in other languages is an asset.

Status

This is an FLSA Exempt position. This is not an OSHA high-risk position.