BILLING SUPERVISOR II

The Billing Supervisor II (Front-End Revenue) is the senior supervisory role within the Billing department and supports the Revenue Cycle Manager in leading the front-end revenue cycle to achieve organizational goals. This role directly supervises the medical coding function (Medical Coder and Senior Medical Coder), the provider enrollment and credentialing function (Provider Enrollment Specialist and Senior Provider Enrollment Specialist), and front-end charge-review and claims staff. The position is accountable for charge capture integrity, accurate code assignment, clean-claim submission, and front-end denial prevention, ensuring work entering the revenue cycle is complete, compliant, and timely so as to enhance revenue, accelerate cash flow, and reduce claim denials. The Billing Supervisor II leads evaluation and training of front-end staff, partners with the Billing Supervisor I (Back-End Revenue) to coordinate hand-offs across the revenue cycle, and works with operational, clinical, and EHR departments to drive process improvements, set priorities, and develop innovative solutions. The Billing Supervisor II ranks above Billing Supervisor I; both report to the Revenue Cycle Manager.

ESSENTIAL JOB FUNCTIONS:

• Demonstrates a thorough and authoritative understanding of Medicare, Medi-Cal, FQHC (Federally Qualified Health Center), state, local programs, and private insurance regulations, and serves as the front-end subject-matter resource.
• Directly supervises the medical coding function: coordinates and monitors the work of the Medical Coder and Senior Medical Coder, ensures coding and documentation comply with ICD-10, CPT, HCPCS, HCC risk adjustment, and CMS NCD/LCD guidelines, and supports timely resolution of coding-related and medical-necessity claim edits.
• Directly supervises the provider enrollment and credentialing function: coordinates and monitors the work of the Provider Enrollment Specialist and Senior Provider Enrollment Specialist, and ensures timely and compliant enrollment, re-credentialing, revalidation, CAQH attestations, and SB 137 provider-data maintenance to prevent enrollment-driven billing disruptions.
• Directs charge review and claim-edit work: oversees front-end claim scrubbing, charge capture validation, and resolution of pre-submission edits to maximize clean-claim rates.
• Provides direction, monitoring, training, and assistance to front-end team members; establishes priorities, assigns and balances workloads, inspects completed work, and resolves escalated front-end issues.
• Conducts probationary and annual evaluations for front-end staff (coding, provider enrollment, charge/claims); for senior specialist roles, evaluations are completed in consultation with the Revenue Cycle Manager and informed by compliance metrics, productivity data, and technical input from subject-matter resources.
• Partners with the Billing Supervisor I (Back-End Revenue) to coordinate clean hand-offs between front-end submission and back-end posting, follow-up, and AR.
• Uses the Epic Professional Billing and Claims environment for charge, code, and claims-library awareness, and coordinates with the Epic Analyst (who owns system configuration) to report, validate, and resolve front-end application issues.
• Monitors front-end denial trends, identifies root causes, and implements process improvements; develops policies and procedures and ensures consistent adoption across the front-end functions.
• Designs and delivers training for new and existing front-end employees on coding, enrollment, charge review, and claims software and workflows.
• Generates and reviews front-end performance reports (coding accuracy, enrollment status, clean-claim and edit rates) for the Revenue Cycle Manager and Administration.
• Performs additional duties as assigned by management.
• Completion of a four-year degree from an accredited university.
• Must hold at least one Epic Resolute Professional Billing (PB) certification. Epic Resolute Claims and Remittance certification is preferred.
• Minimum of three years of supervisory experience in a healthcare revenue cycle, billing, coding, or provider enrollment setting, including experience leading or developing staff.
• At least five years of professional experience in healthcare revenue cycle operations in a complex healthcare or FQHC setting, with front-end (coding, enrollment, charge/claims) exposure.
• Working knowledge of medical coding (ICD-10, CPT, HCPCS, HCC risk adjustment) and provider enrollment / credentialing processes (CAQH, SB 137, payer revalidation) sufficient to supervise these functions; coding credential (AAPC/AHIMA) or equivalent experience preferred.
• Excellent analytical and communication skills, with the ability to convey complex information clearly to technical and non-technical audiences.
• Proficient in computer skills, including billing/coding software and Microsoft Office applications.
• Ability to write clear and professional business correspondence, policies, and procedures.
• Strong organizational skills, with the ability to manage and coordinate multiple front-end processes and personnel simultaneously.
• Committed to maintaining high standards of customer service in a demanding and complex healthcare environment.
• Demonstrates initiative, resourcefulness, integrity, and timeliness to achieve high levels of customer satisfaction.
• Self-motivated, diligent, organized, resourceful, responsible, and enthusiastic in all aspects of work.

LANGUAGE:

• Must be able to fluently speak, read and write English.
• Fluent in Chinese (Cantonese and/or Mandarin) preferred.
• Fluency in other languages is an asset.

STATUS:

This is an FLSA Exempt position.

This is not an OSHA high-risk position.