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Lifeline Connections

We provide confidential, compassionate care to individuals who experience a substance use and/or mental health condition

RCM Medical Billing Operations Supervisor

Medical Billing and CodingMedical Billing and CodingFull TimeRemoteSeniorTeam 201-500Since 1962H1B No SponsorCompany SiteLinkedIn

Location

Washington

Posted

7 days ago

Salary

$21 - $24 / hour

Seniority

Senior

Associate Degree5 yrs expEnglish

Job Description

RCM Medical Billing Operations Supervisor

Lifeline Connections

• The RCM Medical Billing Operations Supervisor position works under the supervision of the RCM Manager. • Oversees the front end of the medical billing cycle, namely timely and accurate claim submission processes. • Supervises the Coding and Claim Review Specialists and Medical Billing Assistant. • Ensures acceptable resolution of failed claims in the EHR to promote timely submission of claims. • Monitors unbilled claims and upfront rejections. • Responsible for coding and mapping in the EHR, maintaining payer information, billing configurations, fee matrices, and rules for the claim engine. • Performs RCM Billing Audits and may assist in running regular reports to track department goals and progress. • Provides direct supervision to the Coding and Claim Review Specialists and Medical Billing Assistant, meeting regularly to provide guidance, direction, support, and resources necessary for efficient job performance. • Conducts quarterly and annual performance evaluations and assists staff in establishing and achieving individual goals aligned with departmental objectives. • Troubleshoots, investigates, and resolves failed claims within the claim management system daily to ensure timely claim submission and reimbursement. • Configures, maintains, and monitors payer billing settings, procedure code, bill-next, and adjustment reason code mappings within billing systems. • Applies proactive problem-solving, analytical thinking, and attention to detail to identify, research, and resolve billing, coding, and claim processing issues.

Job Requirements

  • Associate or bachelor’s degree in medical Billing and Coding, Health Information Management, Healthcare Administration, or a related field preferred.
  • Minimum of five (5) years of experience in medical billing and coding, preferably within a nonprofit healthcare or behavioral health setting.
  • Demonstrated experience working with claims clearinghouses, including identifying, researching, and resolving claim rejections and edits.
  • Working knowledge of electronic claim transactions, including 837 EDI files and related healthcare billing standards.
  • Comprehensive understanding of commercial insurance, Medicare, Medicaid, and managed care billing requirements, including Washington State Provider One Eligibility.
  • Strong knowledge of ICD-10-CM, CPT, HCPCS, HCFA 1500, and UB-04 claim forms, as well as payer-specific reimbursement requirements and regulations.
  • Proficient in Microsoft Excel, including the use of sorting, filtering, formulas, conditional formatting, pivot tables, and data analysis functions.
  • Strong analytical and critical-thinking skills with the ability to identify trends, troubleshoot complex billing issues, and develop effective solutions.
  • Excellent verbal and written communication skills with the ability to communicate clearly and professionally with staff, leadership, payers, and external stakeholders.
  • Reliable attendance and dependability, with a demonstrated commitment to meeting job responsibilities and organizational expectations.

Benefits

  • Multiple options for medical, dental, and vision coverage for employees and their eligible dependents.
  • Employer-paid Short Term Disability, Long Term Disability, and Life Insurance.
  • Access to supplemental coverage options.
  • 401(k) retirement plan for full-time employees.
  • Generous paid time off that increases with years of service.
  • Paid holidays and personal holidays.

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