Job Description

Job Description

Job Description

Overview

The Revenue Cycle Supervisor at Nazareno Services, a leading Medical Equipment provider, is responsible for supporting the oversight and optimization of the revenue cycle process, spanning equipment availability validation, dispatch, and billing. This role ensures efficient departmental operations, compliance with regulatory standards, and exceptional patient service. The Supervisor will collaborate closely with the Revenue Cycle Manager to enhance financial performance, manage staff, and maintain strong relationships with insurance providers and delivery partners.

Core Responsibilities

• Serve as a subject matter expert on prescription orders, coding (CPT and ICD-10), equipment dispatch, inventory management, and billing processes within the DME department.
• Assist in managing patient financial communications, cash revenue cycle, insurance billing, and accounts receivable, ensuring accuracy and timeliness.
• Supervise daily operations, including charge entry, inventory tracking, payment posting, reimbursement management, referral processing, insurance verification, route planning, equipment dispatch, claim submissions, and accounts receivable follow-up.
• Conduct periodic inventory audits to ensure accuracy and availability of DME supplies, such as CGM and insulin pumps.
• Coordinate daily delivery routes, prioritizing urgent requests and adhering to established delivery metrics (e.g., 24-48 hour turnaround).
• Foster strong communication and strategic alliances with delivery companies to ensure seamless logistics, particularly in challenging environments like Puerto Rico.
• Participate in meetings with insurance companies to address billing denials, invoice disputes, and payment status updates.
• Perform audits of existing procedures, identify areas for improvement in billing operations, and implement necessary enhancements.
• Train, assign tasks, and resolve issues among customer service, technical, and billing staff to maintain high performance levels.
• Evaluate service quality across multiple channels and establish performance metrics to drive expected outcomes.
• Conduct quarterly quality audits across all process areas to ensure compliance and efficiency.
• Oversee the training process for new and existing staff, ensuring adherence to company policies, procedures, systems, protocols, and standards through effective supervision.
• Analyze trends in coding, charges, accounts receivable, and collections, delegating actionable tasks to billing personnel.
• Collaborate with other departments to gather and analyze patient data, facilitating accurate billing and processing.
• Implement and enforce billing guidelines, including updates to CPT and ICD-10 codes.
• Utilize the Assertus System (Pro-Claim) to maintain a 91% Clean Claim Ratio, conducting prospective and retrospective billing audits.
• Support the Operations Director and Revenue Cycle Manager during external audits or related process duties.
• Ensure all billing activities comply with payer, state, and federal requirements, regulations, and guidelines, including HIPAA and health information management standards.
• Stay current on evolving regulations and best practices in healthcare billing and compliance.

Requirements:

• Education: Bachelor’s Degree in Business, Management, Healthcare Administration, or equivalent experience.
• Experience: Minimum of three (3) years in a revenue cycle or billing supervisory role within a healthcare or DME setting, with a preference for five (5) years of related experience.
• Technical Skills:
  • Profound knowledge of insurance/healthcare billing, collections, Medicaid, and third-party payer processes.
  • Expertise in CPT and ICD-10 coding, claim forms, HIPAA, clinical terminology, appeal processes, billing regulations, and insurance benefits.
  • Familiarity with basic accounting principles and business management to guide billing and coding operations.
  • Proficiency in electronic health records (EHR) systems and applications.
  • Advanced skills in Microsoft Office (Word, Outlook, Excel) and billing software (e.g., Assertus System).
• Interpersonal Skills:
  • Strong negotiation abilities to engage with insurance companies, customers, and patients regarding financial matters.
  • Exceptional communication skills to interact effectively with staff, colleagues, patients, physicians, and insurers across various platforms.
  • Ability to train, supervise, and motivate employees while organizing, prioritizing, and scheduling tasks to meet deadlines.
  • Fully Bilingual (English and Spanish) preferred.
• Attributes:
  • Detail-oriented with the capacity to perform under pressure and manage frequent interruptions.
  • Demonstrated initiative and ability to work independently with minimal supervision.
  • Proficiency in handling complex, multi-variable problems in an organized manner.

Preferred Qualifications

• Experience in a DME environment, particularly with CGM and insulin pump management.
• Certification in medical billing or revenue cycle management (e.g., CPC, CPB) is a plus.

Working Conditions

• This role may require occasional travel to meet with insurance providers or conduct on-site audits.
• Ability to work flexible hours to accommodate urgent delivery schedules or patient needs.

Equal Opportunity Employer

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