Billing Problem Resolution Supervisor

Billing Problem Resolution Supervisor

Full-time | Santa Ana, CA | hybrid on-site/remote, based on business demand

Position Summary

The Billing Problem Resolution (BPR) Supervisor leads a team of Billing Problem Resolution Specialists responsible for investigating and resolving patient billing concerns, insurance payment issues, eligibility problems, claim status inquiries, denial-related questions, balance disputes, and service recovery requests. This role combines customer service leadership with revenue cycle expertise to improve patient satisfaction, reduce escalations, accelerate issue resolution, and identify root causes impacting reimbursement.

The BPR Supervisor oversees daily operations, staff development, quality assurance, call center performance, workflow optimization, and cross-department collaboration to ensure accurate and timely resolution of billing-related inquiries.

Essential Duties and Responsibilities

Team Leadership

• Supervise Customer Service Representatives and Billing Problem Resolution Specialists. 
• Monitor productivity, quality, and service levels. 
• Conduct coaching, training, and performance evaluations. 
• Manage escalated patient and client complaints. 
• Develop departmental workflows and standard operating procedures. 

Revenue Cycle Analysis

• Review complex patient billing concerns. 
• Analyze claims, remittance data, denials, adjustments, and payment posting activity. 
• Identify root causes of recurring billing issues. 
• Coordinate resolution efforts with Eligibility, Billing, Compliance, Operations, and IT. 
• Escalate systemic issues affecting reimbursement or patient satisfaction. 

Operational Oversight

• Monitor call center metrics and resolution outcomes. 
• Develop reporting dashboards and performance metrics. 
• Lead service recovery initiatives. 
• Support implementation of new technologies and workflow automation. 
• Identify training opportunities based on inquiry trends. 

Continuous Improvement

• Analyze patient complaints and billing trends. 
• Recommend process improvements. 
• Participate in special projects and revenue recovery initiatives. 
• Support automation efforts, self-service tools, and digital patient engagement solutions. 

Qualifications

• Bachelor's degree preferred. 
• 5+ years healthcare revenue cycle experience
• 2+ years leadership experience. 
• Strong understanding of: 
  • Insurance billing 
  • Eligibility verification 
  • Coordination of Benefits (COB) 
  • Medical necessity 
  • Denial management 
  • Patient responsibility calculations 
  • Payment posting 
• Experience with call center operations required. 
• Strong analytical and problem-solving skills.