- Salary
- $70k – $75k/yr
- Location
- Burbank, California
- Type
- Full-time
- Department
- Sales
- Source
- Pinpoint
Description
REVENUE CYCLE SUPERVISOR
Department: Administrative - Other
Employment Type: Full Time
Location: Burbank, CA
Compensation: $70,000 - $75,000 / year
Description
• Department: Revenue Cycle Management (RCM) / Finance
• Reports To: VP of Finance
• Supervisory Scope: Provides day-to-day guidance and oversight to assigned billing, claims, and collections staff, while maintaining an individual workload of operational accounts and claims.
Key Responsibilities
• Personally manage a portfolio of claims, payer accounts, denials, and aged receivables while maintaining consistent follow-up through resolution.
• Monitor the full claims lifecycle, including claim preparation, electronic submission, clearinghouse acceptance, payer adjudication, payment, and resolution of outstanding balances.
• Review claims for completeness and accuracy, investigate rejections or processing errors, and ensure corrections and resubmissions are completed within payer filing limits.
• Use practice management and billing platforms such as CentralReach, AlohaABA, or comparable systems to research claims, document actions, and track results.
• Post or oversee accurate posting of electronic remittance advice (ERA) and explanation of benefits (EOB) information, payments, adjustments, and approved write-offs.
Team Supervision and Workload Management
• Assign and balance daily work queues, payer follow-ups, denial cases, and aging accounts to ensure timely action and clear ownership.
• Monitor staff productivity, work quality, follow-up timeliness, documentation, and resolution rates; provide direct coaching and corrective guidance as needed.
• Serve as the first point of escalation for complex claim issues, payer disputes, billing questions, and workflow barriers.
• Train team members on billing procedures, payer requirements, system workflows, documentation standards, and effective denial-resolution practices.
• Review completed work for accuracy and consistency, reinforce accountability, and communicate priorities and performance expectations.
• Lead brief team huddles or workflow reviews to address backlogs, urgent filing deadlines, high-dollar claims, and recurring issues.
Denial Management and Appeals
• Investigate and resolve denied, rejected, or underpaid claims, including issues involving modifiers, coordination of benefits, eligibility, provider credentialing, authorizations, and documentation.
• Prepare, submit, and track appeals and corrected claims within required payer deadlines.
• Analyze denial patterns and perform root-cause reviews; implement corrective actions and share recurring trends with the RCM Manager and relevant departments.
• Ensure denial notes, payer communications, corrective actions, and appeal outcomes are documented accurately.
Authorization and Service Reconciliation
• Reconcile services rendered against active authorizations, approved units or hours, provider credentials, and applicable billing requirements.
• Monitor authorization utilization and expiration dates, identifying potential unbillable services and escalating discrepancies promptly.
• Partner with clinical, scheduling, intake, and operations teams to resolve authorization gaps, service mismatches, and other barriers to billing.
• Maintain working knowledge of applicable ABA CPT codes, including 97151–97158, and research payer-specific coding, modifier, documentation, and medical necessity requirements.
Accounts Receivable, Collections, and Cash Flow
• Prioritize follow-up based on aging, balance, filing deadlines, and likelihood of recovery, with particular attention to high-value and time-sensitive accounts.
• Conduct payer follow-up with commercial insurers, Medicaid plans, and regional center or other applicable funding networks for unpaid and aged balances.
• Reconcile payments, contractual adjustments, approved write-offs, and outstanding balances; investigate underpayments and payment discrepancies.
• Support appropriate patient and family billing, including copayments, coinsurance, deductibles, payment arrangements, and account inquiries, in accordance with company policy.
• Identify collection risks and promptly escalate material reimbursement delays, payer trends, and accounts requiring leadership intervention.
Reporting, Quality Control, and Process Improvement
• Prepare and maintain reports on clean claim rates, denial rates, collections, work queue status, and accounts receivable aging, including 30-, 60-, 90-day, and older balances.
• Monitor team and individual performance against established productivity, quality, timeliness, and collection goals.
• Provide updates on cash collection forecasts, unresolved payer issues, backlogs, and material reimbursement risks to the RCM Manager or finance leadership.
• Identify opportunities to improve claim accuracy, reduce avoidable denials, shorten resolution times, and strengthen revenue cycle workflows.
• Help standardize procedures, checklists, and documentation practices to improve consistency, training, and operational control.
Compliance and Confidentiality
• Ensure personal work and team activities follow HIPAA, applicable privacy requirements, payer rules, billing guidelines, and company policies.
• Maintain complete, accurate, and confidential billing records and supporting documentation.
• Escalate suspected billing inaccuracies, authorization gaps, compliance concerns, or other high-risk issues to the appropriate leader.
• Promote consistent adherence to established procedures for claim submission, appeals, adjustments, payment posting, and recordkeeping.