Billing Supervisor
hace 1 día
Oradell
Job Description Primary Functions: The Billing Supervisor is responsible for overseeing day-to-day billing operations including Medicaid Fee-for-Service, Managed Care Organizations (MCOs), and private pay accounts. This role ensures accurate, timely claim submission; monitors insurance eligibility; tracks unpaid and denied claims; and produces regular billing and revenue reports. In addition, the Billing Supervisor oversees and helps coordinate internal processes to support ongoing insurance coverage continuity for the individuals served by the organization, helping to reduce lapses in coverage that can disrupt services and reimbursement. The Billing Supervisor directly supervises and trains two full-time billing staff and plays a hands-on role in maintaining compliance, improving collections, and strengthening revenue cycle processes. This position with be from Monday through Friday (8:30 a.m. to 4:15 p.m.) Essential Functions: Essential Duties and Responsibilities Billing Operations & Revenue Cycle Management • Oversee accurate and timely submission of claims to Medicaid Fee-for-Service, Medicaid MCOs, and private insurance carriers., • Ensure compliance with payer requirements, billing rules, and documentation standards., • Monitor insurance eligibility, authorizations, and coverage changes prior to billing., • Track claim status from submission through payment, including follow-up on unpaid, underpaid, or denied claims., • Identify and resolve billing errors, rejections, and denials in a timely manner., • Coordinate with clinical, program, and administrative staff to resolve billing discrepancies and documentation issues. Insurance Coverage Continuity & Eligibility Oversight • Oversee processes to monitor and support ongoing insurance eligibility and coverage for individuals served., • Collaborate with Program Directors and the Documentation and Scheduling Coordinator to develop, implement, and refine workflows that help prevent lapses in insurance coverage., • Establish clear internal procedures for identifying upcoming eligibility renewals, coverage terminations, or changes impacting billing., • Ensure timely communication to appropriate staff when coverage issues may affect service delivery or reimbursement., • Track trends related to coverage loss, reinstatements, and delays, and report systemic issues to finance and program leadership., • Supervise, train, and support two full-time billing staff., • Assign workloads, monitor productivity, and ensure deadlines are met., • Provide ongoing training on billing procedures, payer rules, and internal systems., • Review staff work for accuracy and completeness and provide corrective guidance as needed., • Maintain detailed tracking of claims submitted, payments received, outstanding balances, denials, and write-offs., • Prepare regular billing and accounts receivable reports for the CFO., • Flag trends related to delayed payments, denials, or payer issues., • Assist with month-end close activities related to billing and revenue., • Stay current on Medicaid, MCO, and private insurance billing requirements., • Assist in maintaining written billing policies and procedures., • Recommend process improvements to increase efficiency, accuracy, and collections. Required • Minimum 3-5 years of healthcare billing experience, including Medicaid billing., • Experience billing Medicaid Fee-for-Service and Managed Care Organizations (MCOs)., • Demonstrated experience tracking claims, denials, and accounts receivable., • Prior experience supervising or training billing staff., • Strong understanding of insurance eligibility verification and authorization processes., • Ability to collaborate effectively across departments, including program and administrative teams., • Proficiency with electronic billing systems and Microsoft Excel., • Strong attention to detail, organization, and follow-up skills., • Experience in a nonprofit, behavioral health, developmental disabilities, or community-based healthcare setting., • Familiarity with New Jersey Medicaid systems, eligibility redetermination processes, and managed care payers., • Knowledge of healthcare compliance, audits, and documentation requirements. Work Environment & Expectations · Office-based or hybrid, depending on organizational needs. · Moderate deadline-driven workload, particularly around billing cycles, eligibility renewals, and month-end reporting. · Hands-on role requiring both leadership and direct billing involvement. North Jersey Friendship House (NJFH) is an equal opportunity employer.