Medical Billing Supervisor

5 days ago

Pasay, National Capital Region, Philippines Infinit-O Full time ₱1,200,000 - ₱2,400,000 per year

We are seeking a highly motivated and experienced Medical Billing Supervisor to oversee our daily billing and claims operations. This role is responsible for the performance of the billing team, ensuring accuracy, efficiency, and compliance throughout the revenue cycle, specifically for Medicaid claims. The ideal candidate will be a hands-on leader who can troubleshoot complex billing issues, train staff, and drive the team to meet key performance metrics.

Key Responsibilities:

  • Team Supervision and Workflow Management:

  • Supervise the day-to-day activities of a team of Medical Billers and Claims Specialists.

  • Monitor daily workflow from claim generation to payment posting to ensure tasks are completed accurately and on time.
  • Distribute and balance workloads among team members to meet departmental goals and deadlines.

  • Performance Monitoring and Reporting:

  • Track and report on team performance against key metrics, including clean claim rate, denial rate, and accounts receivable (A/R) aging.

  • Identify trends and patterns in billing data to proactively address issues and improve processes.
  • Escalate complex or systemic billing issues to the Medical Billing Manager with clear, data-backed recommendations.

  • Troubleshooting and Denial Resolution:

  • Serve as the primary escalation point for the team on complex or difficult-to-resolve billing issues, particularly with Medicaid claims.

  • Assist the team with preparing and submitting high-level appeals for denied claims.
  • Liaise with Medicaid payer representatives to resolve disputes and clarify billing guidelines.

  • Training and Development:

  • Train new billing staff on our specific workflows, software, and compliance procedures.

  • Provide ongoing training and coaching to the existing team to ensure they are up-to-date on Medicaid policies and best practices.
  • Develop and maintain documentation of billing procedures and workflows.

  • Quality and Compliance:

  • Ensure all billing practices adhere to HIPAA, Medicaid, and other state and federal regulations.

  • Monitor changes in Medicaid policies and communicate them effectively to the billing team.
  • Support the manager in preparing for and conducting internal and external audits.
  • Conduct regular quality assurance audits on claims to identify and correct errors before submission.

Required Qualifications:

  • Experience:

  • Minimum of 5+ years of experience in medical billing, with at least 1-2 years in a lead or supervisory role.

  • Extensive, hands-on experience with Medicaid claims processing is essential.
  • Proven ability to manage and motivate a team to achieve performance targets.

  • Technical Skills:

  • Advanced proficiency with Electronic Health Record (EHR) and practice management systems.

  • Strong analytical skills with a high degree of proficiency in data analysis using tools like Microsoft Excel.

  • Certifications:

  • A professional billing certification (e.g., AAPC's Certified Professional Biller - CPB) is highly preferred.

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