L5 – Supervisor – (NS_E&B_WWS & NS_ARM

Role Overview:
As an L5 Supervisor – Medical Billing, you will be responsible for overseeing the operations of the billing team, focusing on the Eligibility & Benefits (NS_E&B_WWS) and Accounts Receivable Management (NS_ARM_WWS) functions within the revenue cycle. Your role will include managing the team’s day-to-day activities, ensuring accurate and timely processing of eligibility verification, benefits determination, accounts receivable, and claim follow-ups. You will ensure compliance with payer policies, healthcare regulations, and internal guidelines, while also identifying opportunities for operational improvements and process optimization.

Key Responsibilities:

Team Supervision & Leadership:
Lead, manage, and mentor a team responsible for eligibility & benefits verification and accounts receivable management. Ensure the team adheres to processes and maintains high standards for accuracy and efficiency.
Eligibility & Benefits Verification (NS_E&B_WWS):
Oversee the process of verifying patient eligibility and determining insurance benefits. Ensure timely and accurate processing of eligibility inquiries, and ensure that coverage information is captured correctly for billing.
Accounts Receivable Management (NS_ARM_WWS):
Supervise the management of accounts receivable, ensuring timely follow-up and resolution of outstanding claims, and minimizing the risk of claim denials. Monitor aging accounts and ensure the appropriate escalation of unresolved issues.
Claims Follow-Up & Denial Management:
Oversee the tracking and follow-up on denied claims, ensuring that disputes are resolved, and claims are resubmitted as needed. Work with insurance companies to address payment issues and denials efficiently.
Billing Compliance & Regulatory Adherence:
Ensure all billing and accounts receivable activities comply with relevant healthcare regulations, payer requirements, and internal policies. Stay updated on industry changes and ensure the team follows updated protocols.
Process Improvement & Efficiency:
Identify inefficiencies in the eligibility verification and accounts receivable processes and recommend or implement improvements to increase productivity, reduce denials, and optimize cash flow.
Reporting & Performance Metrics:
Prepare and present reports on key performance metrics, such as eligibility verification accuracy, accounts receivable aging, claims follow-up status, and payment collections. Use data to identify trends and areas for improvement.
Collaboration & Cross-Functional Support:
Work closely with other departments, including coding, billing, and insurance verification, to address any issues in the revenue cycle and support efficient claims processing. Provide support to other teams as necessary.
Training & Development:
Provide training and guidance to billing team members on eligibility verification procedures, accounts receivable management, and system processes. Foster a culture of continuous learning and development within the team.
Problem Resolution & Escalation:
Act as a point of escalation for complex billing or accounts receivable issues. Ensure timely resolution of complex payment issues and ensure that team members are equipped to handle challenging situations.

Desired Candidate Profile:

Bachelor’s degree in Healthcare Administration, Medical Billing, Health Information Management, or a related field.
Certification in Medical Billing (e.g., CBCS, CCB, or equivalent) is preferred.
Minimum of 5 years of experience in medical billing, with at least 2 years in a supervisory or leadership role within revenue cycle operations.
Strong knowledge of eligibility & benefits verification, accounts receivable management, and healthcare billing systems.
In-depth understanding of payer requirements, healthcare regulations, and revenue cycle processes.
Proven ability to lead and motivate a team, with excellent interpersonal and communication skills.
Strong problem-solving and analytical abilities.
Proficiency in medical billing software, Electronic Health Record (EHR) systems, and other related tools.

What We Offer: