Role Description The RCM Reimbursement Supervisor is responsible for overseeing the billing, collections, and reimbursement operations within the revenue cycle, ensuring compliance with HIPAA, Medicare/Medicaid, private payor, and regulatory requirements. This role supervises internal teams and external vendors, ensures prompt and accurate claim resolution, and implements best practices to optimize collections, reduce denials, and meet key performance indicators such as cash goals, aging, quality, and productivity. The Supervisor plays a key role in team training, operational improvements, and the use of technology to enhance efficiency and compliance. Major Areas of Accountability - Conduct business to the highest ethical and professional standards. - Comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies. Leadership & Team Management: - Supervise and support billing and collections teams, including vendor liaisons. - Train and onboard new team members; monitor performance and provide ongoing coaching and development. - Ensure adherence to departmental policies, HIPAA and PHI regulations, and corporate compliance standards. - Promote a positive team culture by encouraging individual growth, accountability, and cross-functional collaboration. - Act as point of contact for internal and external stakeholders for escalations, inquiries, and operational issues. - Lead and participate in operational projects, system upgrades, and departmental initiatives. - Facilitate best practice sharing across departments and assist leadership in implementing constructive changes. Revenue Cycle Oversight: - Oversee billing, collections, and reimbursement functions, including claim submissions, payment posting, denial management, and patient responsibility determinations. - Review and resolve claim rejections and exceptions; ensure appropriate follow-up on aged accounts and outstanding A/R. - Utilize knowledge of payer policies, DME billing guidelines, and coding (ICD, CPT, HCPCS) to ensure clean claim submission and low denial rates. - Ensure timely processing of all account correspondence, refunds, adjustments, and re-billing as needed. - Manage relationships with external collection vendors, ensuring compliance with contractual obligations and alignment with performance goals. - Collaborate with insurance verification, medical records, payment posting, and patient pay teams as needed to support full-cycle resolution. Reporting & Analysis: - Generate, analyze, and distribute key performance reports on production, inventory, aged accounts, denial trends, and vendor performance. - Monitor team productivity and identify areas for process improvement; assist with implementation of new tools and technologies. - Use data analysis (including Excel and Power BI) to develop actionable insights and support decision-making. Compliance & Quality Assurance: - Ensure operations comply with all regulatory guidelines, including HIPAA, Medicare/Medicaid, third-party payors, OSHA, and accrediting agencies. - Identify and escalate non-compliant activity; participate in audits and quality assurance reviews. - Maintain accurate documentation in billing systems and CRM per company standards. Additional Responsibilities: - Act as trusted advisor to our Comfort Medical management team on select projects and tasks. - Facilitate sharing of operational best practices across departments within the organization. - Travel as required for vendor meetings or departmental support. - Other duties as assigned. Qualifications - High School diploma required. - Minimum of 5 years of experience in healthcare payor and/or provider settings, with strong functional knowledge in revenue cycle management. - Minimum of 4 years of experience in Durable Medical Equipment (DME). - At least 4 years’ experience in billing, collections, and payment posting. - Strong knowledge of governmental and commercial payors, billing codes (ICD, CPT, HCPCS), EOBs/ERNs, and payer compliance rules. - Strong proficiency in Microsoft Excel and Power BI Apps. - Excellent communication, leadership, and analytical skills. - Ability to work both independently and as part of a team. Preferred Qualifications - Bachelor's degree preferred. Benefits - Comprehensive medical, dental, and vision insurance plans. - Access to company-sponsored wellness programs and mental health resources. - Paid leave of absence for qualifying events and generous paid parental leave. - A competitive 401(k) plan with company match that vests immediately. - Financial planning services and corporate discount programs. - Generous paid time off, flexible work hours, and flexible work arrangement options. - Opportunities for continuous learning and career advancement through training programs, mentorship, and tuition reimbursement. - Recognition programs to celebrate achievements and contributions. - A supportive work environment with team-building activities and volunteer opportunities. - Competitive compensation range of $81,513 - $122,269.