Supervisor HME Billing

Purpose of Job The HME Billing Supervisor provides direct supervision to assigned staff and is responsible for coordinating and overseeing billing activities specific to Durable Medical Equipment (DME). This role supports HME department leadership by ensuring that DME claims, documentation, authorizations, reimbursements, and patient account processes are completed accurately and timely in accordance with departmental policies, payer requirements, accreditation standards, and applicable federal and state regulations.

Additionally, the HME Billing Supervisor will work with department leadership to oversee and resolving claim rejections and denials and implementing strategic process improvements to secure the department’s financial viability. Job Functions Provides direct supervision of the Reimbursement Representatives in Ridgevew Home Medical Equipment. Supports the department director/manager through development of programs, goals and objectives consistent with those of the organization's overall strategic plan and initiatives.

Supervises staff resources by overseeing the recruiting, selecting, hiring and orienting qualified individuals. Evaluates staff performance in an accurate, consistent, objective and timely manner. Assists in the development of core position hiring strategies and ensure opportunities for professional development.

Serves as a resource to staff by answering questions, assisting with problems, and providing training as necessary. Implements quality and performance improvement measures for the billing department. Supports department director/manager in quality improvement efforts and service delivery that contributes to the overall success and financial viability of Ridgeview Home Medical Equipment.

Reviews and monitors applicable processes, policies and procedures. Ensures compliance with local, state and federal regulatory agency standards. Reviews and resolves issues related to claim generations, rejected, denied billings.

Determines the accuracy of HCPCS, missing charges, late charges, covered and non-covered charges. Ensures timely submission and acceptance of claims to all payers. Proactively identifies and actus upon improvement projects and opportunities through observation, data analysis, engagement with partners, review of external impact factors and best practices, as well as ongoing communication with leadership and staff.

Elevates issues with payers and reports improvement as appropriate. Carries out functions to assist department director/manager with vendor management to include access, invoicing, and customer service. Other duties as assigned.

Minimum Education/Work Experience High School Diploma or equivalent 1+ years experience in DME, Hospital and/or Clinic billing experience with emphasis on accurate and timely billing, insurance claims management, patient account management, compliance and regulation knowledge. Knowledge/Skills/Abilities Professional presence and effective interpersonal skills Ability to meet and maintain the necessary background checks as aligned with position functions Ability to communicate in the English language for effective written and verbal correspondence in order to complete job functions as mentioned above Demonstrated ability to supervise and coach a team Excellent communication and influencing skills and ability to build strong working relationships at all levels Ensures excellent service with a high degree of urgency to internal and external customers Demonstrated computer aptitude in computer programs including but not limited to mastery of the Microsoft suite as well as familiarity with HR-specific platforms for timekeeping and scheduling and HME-specific program Knowledge of insurance functions Capable of making independent decisions with the use of good critical thinking and problem-solving skills Maintains current knowledge of insurance claims processes, compliance changes and regulation updates License/Certifications

Supervisory experience in leading a small team Familiarity with medical terminology Familiarity with Brightree software Familiarity with Epic software Compensation Many factors are taken into consideration when determining compensation such as: the requirements of the position, experience, education, knowledge, and skills along with location and internal equity. Pay listed does not include any shift, weekend, or other differentials.

Benefits Ridgeview strives to provide comprehensive and market competitive benefits to meet the needs of our employees and their families. Click here to view the benefits available.