Billing Supervisor

About the Role

Under the direction of the Chief Financial Officer (CFO), the Billing Supervisor provides strategic and hands‑on leadership for all FQHC revenue cycle operations. The role is directly responsible for closely monitoring accounts receivable, driving measurable improvements in collection rates, and implementing ongoing staff training to ensure billing compliance, denial reduction, and revenue optimization. The Billing Supervisor ensures integration between clinical operations, finance, billing vendors, and payers with deep focus on FQHC‑specific requirements including Medicare/Medicaid cost reporting, sliding fee scale, and encounter data integrity. The position includes provider credentialing responsibilities and supervises billers and coders.

Responsibilities

• Provider Credentialing & Enrollment
  • Manage and oversee the full lifecycle of provider credentialing and enrollment for all billable providers.
  • Ensure all providers are credentialed and enrolled with Medicare, Medicaid, and all commercial/managed‑care payers prior to their start date and maintained current thereafter.
  • Coordinate with HR and clinical leadership to onboard new providers, including completion of CAQH, state licenses, DEA, and payer applications.
  • Re‑credential providers according to payer schedules (typically every 3 years) and ensure no lapse in reimbursement eligibility.
  • Investigate and resolve credentialing‑related claim denials (e.g., provider not on file, non‑participating status) in collaboration with billing staff.
  • Ensure timely submission of provider demographic changes (address, NPI, taxonomy practice location) to all payers.
• Accounts Receivable – Close Monitoring
  • Perform daily and weekly reviews of AR aging reports by payer (Medicare, Medicaid, Commercial, Self‑Pay) and by service (medical, dental, behavioral health, case management).
  • Monitor days in accounts receivable (DAR), gross/net collection rates, and percentage of AR > days; present findings to CFO and department leadership.
  • Reconcile payer payments to contracts monthly, identifying underpayments, timely‑filing denials, precertification and pre‑authorization denials, and FQHC‑specific reimbursement shortfalls.
  • Oversee uncollectible account reviews and write‑off approvals in compliance with FQHC sliding‑scale fee policies.
• Improving Collection Rates
  • Develop and implement strategies to reduce self‑pay AR through improved sliding fee scale determination at registration, payment‑plan options, and follow‑up protocols.
  • Lead denial management efforts focusing on top FQHC denial reasons (e.g., missing encounter data, incorrect place of service, missing sliding fee documentation, prior‑authorization gaps, timely filing).
  • Collaborate with the PSR Manager to reduce registration‑related collection barriers (e.g., incomplete sliding fee applications, inaccurate or missing insurance capture, missed self‑pay collections at check‑in).
  • Establish and monitor collection KPIs by provider, site, and payer.
• Sliding Fee Discount Program
  • Own and administer the organization’s Sliding Fee Discount Program in compliance with HRSA FQHC requirements.
  • Develop, maintain, and annually update the Sliding Fee Scale Policy, discount tiers, and eligibility criteria.
  • Ensure all patients are screened for sliding fee eligibility at registration and recertified annually.
  • Oversee the accurate processing of sliding fee applications, income verification, and discount application within the EMR.
  • Conduct quarterly internal audits