POSITION SUMMARY:
The Billing Supervisor is responsible for overseeing the day-to-day operations of the Billing Department while actively performing billing duties and maintaining an assigned workload. This is a working supervisory position that requires the incumbent to both lead and support billing staff and independently complete billing functions to ensure accurate, timely, and compliant claims processing and reimbursement.
The Billing Supervisor provides direction, training, and support to billing staff; monitors departmental productivity and performance; and assists with the resolution of complex billing, claims, payment, and reimbursement issues. In addition to supervisory responsibilities, the position is directly responsible for processing and submitting assigned claims, researching, and resolving billing issues and denials, following up on outstanding accounts, and completing other revenue cycle functions as assigned.
The Billing Supervisor works collaboratively with clinical, administrative, and financial departments to maintain efficient billing workflows, maximize reimbursement, minimize errors and denials, and ensure compliance with applicable regulations, payer requirements, and organizational policies. The position also supports staff development, performance management, reporting, process improvement, and the implementation of departmental goals and objectives.
ESSENTIAL FUNCTIONS:
1. Supervises and supports Billing Department staff under the direction of the Billing Director, including assigning and monitoring work, managing staff schedules and department coverage, reviewing and approving time-off requests, approving employee timecards, monitoring attendance, conducting regular one-on-one check-ins, providing training and guidance, and addressing performance concerns.
2. Establishes, communicates, and monitors individual and departmental goals and objectives in collaboration with the Billing Director. Conducts regular follow-up with staff to evaluate progress, provides coaching and feedback, and holds employees accountable for achieving established performance expectations.
3. Completes and participates in employee performance management activities, including introductory and annual performance evaluations, performance feedback, documentation, recognition, corrective action, and performance improvement plans when appropriate. Ensures follow-up on identified performance issues and expectations.
4. Personally, performs assigned billing and revenue cycle functions for medical, dental, and behavioral health services, including preparing and submitting claims to Medicare, Medi-Cal/Medicaid, managed care, commercial payers, patients, and other third-party payers.
5. Processes and reconciles billing transactions, including posting payments, electronic remittances (835 files), patient payments, adjustments, daily batches, and patient account activity while verifying the accuracy of financial data.
6. Monitors accounts receivable, aging, unpaid claims, and patient and payer balances to support timely reimbursement and meet collection goals established by the Billing Director.
7. Research, resolves, and follows up on billing issues, denials, and unpaid claims, including initiating claim tracers, reprocessing claims, preparing appeals, and identifying trends or training needs related to denials and billing errors.
8. Coordinates coding and billing processes to ensure accurate and timely claim submission and compliance with applicable billing and coding regulations, including ICD-10-CM and annual code set updates. Maintains current knowledge of FQHC, Medicare, Medi-Cal, Medicaid, commercial HMO/PPO, managed care, and other applicable payer requirements and provides training to staff as needed.
9. Prepares, reviews, and distributes billing, revenue, aging, productivity, and other financial reports and statistics as directed by the Billing Director, including monthly reporting, reconciliation activities, and monitoring departmental performance against established goals.
10. Maintains accurate billing records and supporting documentation, responds to patient, payer, and internal billing inquiries, participates in compliance and documentation audits, maintains strict confidentiality of health and financial information, and performs other related billing and supervisory duties as assigned.
ADDITIONAL RESPONSIBILITIES:
1. May assist in preparing documents and responses for legal inquiries, litigation, and court appearances.
2. Assists in training and maintaining reference materials for front and back-office staff as related to reimbursement system.
3. Performs a variety of general clerical duties, including telephone, mail distribution, and other business functions.
4. Under the direction of the Billing Director, participates in development of organization procedures and updates of forms and manuals.
5. May assist Billing staff with insurance verification as necessary.
KNOWLEDGE, SKILLS AND ABILTIES:
1. Ability to read and interpret policies and procedures from a variety of sources.
2. Knowledge or ability to learn FQHC billing process as well as Medi-Cal and Medi-Cal managed care required.
3. Ability to work in a paper and electronic health information environment and be able to support electronic claims and occasional paper claims.
4. Knowledge of electronic health records system required.
5. Ability to be an effective supervisor.
6. Ability to communicate well verbally and in written communication internally with staff and externally with patients, vendors, and outside agencies.
7. Knowledge of computers and programs to generate reports using MSWord and MS Excel products.
8. Knowledge of HIPAA privacy and security requirements required.
9. Ability to work in a detailed, organized manner.
10. Demonstrate awareness, sensitivity, and appreciation of Native American culture, traditions, customs, and socio-economic needs.
11. Ability to record information accurately and timely.
12. Ability to operate computer terminal, 10-key adding machine, and fax machine.
13. Ability to learn new technology and programs, as necessary.
14. Ability to work independently with minimal supervision.
EDUCATION AND EXPERIENCE:
1. Education: High school diploma or GED equivalent required. College education or relevant formal training may substitute for up to one (1) year of required experience.
2. Billing and Collections Experience: Minimum of three (3) years of experience in medical group practice, clinic, or healthcare billing and collections, including eligibility verification and billing for commercial HMO, PPO, EPO, Medi-Cal, Medicare, auto insurance, CHDP, and other third-party payers.
3. Coding Experience: Minimum of three (3) years of healthcare coding experience with knowledge of applicable coding guidelines and requirements is preferred.
4. Electronic Systems Experience: Minimum of three (3) years of experience working in an electronic healthcare, billing, or data-processing environment, with demonstrated ability to accurately enter, retrieve, analyze, and maintain electronic records.
5. Supervisory Experience: Minimum of two (2) years of experience supervising, leading, or overseeing billing staff, including assigning work, monitoring productivity and accuracy, providing coaching and training, conducting performance evaluations, and holding staff accountable to established expectations.
6. Indian Health Service Experience: Experience working within an Indian Health Service or Tribal healthcare environment is preferred.
PHYSICAL REQUIREMENTS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disability to perform the essential functions.
While performing the duties of this job, the employee is regularly required to use hands to finger, handle or feel; reach with hands and arms, stoop; and talk and hear within normal range. The employee is frequently required to stand, walk, or sit. The employee must regularly be able to lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. This position is physically and emotionally challenging. There is a high degree of stress. Ability to deal with time constraints and emotional stress are also essential functions of this job.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly exposed to odors and airborne particles. The noise level in the work environment is usually moderate.
Feather River Tribal Health, Inc. is a drug and alcohol-free workplace. As a federally funded Tribal Health Program, FRTH must comply with Executive Order No. 12564 (Sept. 15, 1986)(51 F.R. 32889 (requiring a Drug Free Workplace) and the Drug Free Workplace Act of 1988 (U.S.C. 8101-8106). As such, FRTH does require drug testing at the time of hire and upon reasonable suspicion after hire. All FRTH employees are required to comply with FRTH’s drug free workplace policies and applicable federal laws as a condition of employment.
Reasonable accommodations will be given to qualified disabled applicants pursuant to Section 501 of the Rehabilitation Act of 1973, 29 U.S. Code 791, Title 29, and the Americans with Disabilities Act (ADA).
Compensation & Benefits:
Hourly Rate: $32.53-33.84, depending on experience
Health Insurance: Employer-paid medical coverage starting the month after hire for all tiers — Self, Self + One, and Self + Family
Dental & Vision: 100% employer-paid for employee-only coverage; additional family coverage available at a competitive rate
401(k) Plan: Available immediately upon hire with a 4% employer match
Life Insurance: $20,000 employer-paid policy for full-time employees, with options to purchase additional coverage
Paid Time Off: Vacation begins accruing on your first day — up to 80 hours annually
Loan Repayment Assistance Available
