Professional Billing & Follow-Up/Denials Supervisor

About the Role

The supervisor leads 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.

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 related to AR follow-up, denials management, underpayment recoupment, and credit balance resolution.
• Consistently complete performance monitoring processes and implement corrective actions as required.
• Monitor, analyze, and report key revenue cycle metrics to ensure alignment with CCHC leadership and MGMA Key Performance Indicators (e.g., Days in A/R, Aged A/R, Denial rates).
• Define and implement action plans when performance is not meeting expectations.
• Maintain up-to-date knowledge of regulatory and compliance changes impacting the area of responsibility and ensure employees are appropriately educated and processes are modified as needed.
• Ensure employees and vendor staff comply with established policies, processes, and quality assurance programs, addressing 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 causes to implement corrective strategies.
• Support implementation of changes needed to address payer contract changes, regulatory requirement changes, and overall processing efficiency.
• Confirm that all control processes effectively minimize denial appeal-related timely filing denials.
• Collaborate with other disciplines to implement changes needed for payer contract and regulatory requirement changes.
• Maintain positive relationships with key payers; attend monthly meetings to discuss reimbursement issues and payer publication notices affecting claims processing and account follow-up.
• Support work needed for external audits.
• Assist in department functions/responsibilities as needed based on volume and workload.
• Challenge current working practices; identify process improvement opportunities and present recommendations and solutions to management.
• Engage in and commit to the organization’s culture of continuous improvement by actively participating, supporting, and promoting CCHC Pillars of Excellence.

Requirements

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

Skills

• 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, physicians, outside vendors, and consultants.
• Capable of learning reporting systems and other new tools.
• Exceptional time management skills.

Schedule

Full-Time, Monday-Friday, with occasional evenings, weekends, and holidays. Remote candidates considered.

Pay

Hiring pay range: $70,000 - $90,000 annually, based on full-time employment.