BILLING SUPERVISOR II

About the role

The Billing Supervisor II (Front-End Revenue) is the senior supervisory role within the Billing department and supports the Revenue Cycle Manager in leading the front-end revenue cycle to achieve organizational goals.

Responsibilities

• 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-CCLAIM 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.
• Worked 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.
• Able 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.