Professional Billing & Follow-Up/Denials Supervisor

Cape Cod Healthcare; Hyannis (MA); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Cape Cod Healthcare in Hyannis, MA is seeking a Revenue Cycle Supervisor for Professional Billing AR Resolution to lead billing, follow-up and denial management, optimizing reimbursement and cash flow while ensuring regulatory compliance.

You will oversee PB billing teams, collaborate with Revenue Cycle, define improvement strategies, monitor key metrics, and drive continuous process enhancements. Remote candidates considered; full-time.

Qualifications

• Bachelor's degree related to Business Administration or Healthcare preferred.
• Minimum two years’ experience in healthcare revenue cycle methodologies.
• Supervisory experience in healthcare environment preferred.
• Experience with professional billing/registration systems and regulatory requirements.

Responsibilities

• Oversee day-to-day operations of the Billing and Follow Up teams to ensure professional (PB) claims are worked timely and accurately.
• Collaborate with Revenue Cycle teams to ensure compliant and accurate billing of claims, facilitating problem resolution of billing issues.
• Define, implement, and monitor strategies to improve billing and accounts receivable management processes.
• Oversee performance and productivity measures of the team as it relates to AR follow-up, denials management, underpayment recoupment and credit balance resolution.
• Consistently complete performance monitoring processes and implements corrective actions as required.
• Monitor, analyze and report key revenue cycle metrics to ensure alignment with leadership and KPIs; define and implement action plans when needed.
• Maintain knowledge of regulatory and compliance changes; educate staff and modify processes accordingly.
• Ensure staff and vendors comply with policies and QA programs; address non-compliance.
• Evaluate and implement opportunities for workflow automation and optimization.
• Partner with IT to leverage technology and improve efficiency.
• Use reporting to identify trends, risks, opportunities and root causes for corrective strategies.
• Support changes needed to address payer contract changes and regulatory updates.
• Ensure timely filing and denial appeal processes are minimized.
• Collaborate with other disciplines to implement payer changes.
• Maintain relationships with payers; discuss reimbursement issues and notices.
• Support audits and department workload adaptations.
• Identify process improvements and promote a culture of continuous improvement.

Skills

Leadership

Communication

Time management

Coaching staff

Problem solving

Education

Bachelor's degree in Business Administration or Healthcare

Tools

Billing systems

Registration systems

Job description

Purpose of Position:

The supervisor is responsible for leading professional billing, accounts receivable follow-up and denial management operations to optimize reimbursement, improve cash flow, reduce revenue leakage and ensure regulatory compliance. This position provides strategic and operational leadership, leverages technology and industry benchmarks and partners across Revenue Cycle functions to drive continuous improvement.

Description

• Oversee day-to-day operations of the Billing and Follow Up teams to ensure professional (PB) claims are worked timely and accurately. Position will work under the supervision of the Manager of Professional Billing AR Resolution.
• Collaborate with Revenue Cycle teams to ensure complaint and accurate billing of claims, facilitating problem resolution of billing issues.
• Define, implement, and monitor strategies to improve billing and accounts receivable management processes.
• Oversee performance and productivity measures of the team as it relates to, AR follow-up, denials management, underpayment recoupment and credit balance resolution.
• Consistently complete performance monitoring processes and implements corrective actions as required.
• Monitor, analyze and report key revenue cycle metrics to ensure the team is aligned with CCHC leadership and the MGMA Key Performance Indicators such as Days in A/R, Aged A/R, Denial rates, etc. Define and implement action plans when performance is not meeting expectations.
• Maintain up-to-date knowledge of regulatory and compliance changes impacting area of responsibility and ensures employees are appropriately educated and processes are modified as needed.
• Ensure employees and vendor staff who are performing functions are doing it in a manner which complies with established policies, processes and quality assurance programs and addresses areas of non-compliance.
• Evaluate and implement opportunities for workflow automation and optimization.
• Partner with CCHC IT analysts to leverage technology and improve efficiency.
• Utilize technology and reporting to identify trends, risks, opportunities and root cause to implement corrective strategies.
• Support implementation of changes needed to address payer contract changes and payer/regulatory requirement changes and to improve overall processing efficiency.
• Confirm that all control processes are effectively minimizing denial appeal related timely filing denials.
• Collaborate with other disciplines to implement changes needed to address payer contract changes and regulatory requirement changes.
• Maintain positive relationships with; attends monthly meetings with key payers to discuss reimbursement issues and payor publication notices affecting claims processing and account follow-up.
• Support work needed for external audits
• Support and assist in department functions/responsibilities as needed based upon volume and workload.
• Challenges current working practices; identifies process improvement opportunities and presents recommendations and solutions to management. Engages and commits to the organization’s culture of continuous improvement by actively participating, supporting, and promoting CCHC Pillars of Excellence.

Qualifications

• Bachelor's degree related to Business Administration or Healthcare preferred.
• Minimum two years’ experience required in healthcare revenue cycle methodologies.
• Supervisory experience in healthcare environment preferred.
• Experience and knowledge of professional billing/registration systems.
• Experience and knowledge of regulatory requirements, payer requirements and reimbursement.
• Excellent communication and interpersonal skills.
• Ability to evaluate personal performance against established goals.
• Ability to coach and support staff in their efforts to improve overall performance.
• Ability to communicate with a wide variety of CCHC and external users, including senior management and physicians, as well as outside vendors and consultants.
• Capable of learning reporting systems and other new tools.
• Exceptional time management skills.

Schedule Details:

Full-Time, Monday-Friday, Occasional Evenings, Weekends, & Holidays. Remote Candidates Considered.

Organization:

Cape Cod Healthcare, Inc.

Primary Location:

Massachusetts-Hyannis

Department:

HCI-Revenue Cycle Physicians

Annual/Hourly:

Annual - Based on Full Time Employment

Hiring Pay Range:

70000 - 90000