Supervisor, Revenue Cycle Business Services HB in Dallas, Texas at TEXASCONNECT INC

The Supervisor, Revenue Cycle Business Services – Hospital Billing (HB) provides day-to-day supervision of the hospital system's billers and account follow-up representatives, ensuring daily work is completed accurately, on time, and to productivity and quality standards. This role is the first line of escalation for complex claim edits, no-response claims, denials, underpayments, and aged accounts, and coaches staff to work accounts to resolution rather than simply document status. The Supervisor assigns and balances work across Epic Resolute HB work queues, monitors team performance key revenue cycle metrics, and partners with HIM/Coding, Patient Access, and Epic application teams to remove barriers and address recurring payor and workflow issues.

SPECIFIC SKILLS NEEDED

• Strong, hands-on experience with Epic Resolute Hospital Billing (HB), including claim edit, follow-up, and credit work queues, liability buckets, Claim Status Insights, and Follow-Up Activities
• Experience working within a clearinghouse and payor portals to research claim status, resolve rejections, and submit corrections and appeals
• Ability to interpret contractual agreements, understand reimbursement methodologies, perform payment variance analysis, and underpayment recovery activities
• Strong knowledge of facility (UB04) claim requirements, revenue codes, DRGs, and hospital reimbursement methodologies
• Working knowledge of CMS billing and reimbursement rules (Medicare and Medicaid) and commercial payor requirements, including timely filing and appeal rights
• Working knowledge of coordination of benefits (COB) rules and primary/secondary payor determination
• Strong critical thinking and problem-solving skills, with the ability to identify root causes and move accounts and claims to resolution
• Strong communication and coaching skills, with the ability to give clear, constructive feedback and direct the work of others
• Proficient in Microsoft Excel for tracking and reporting.

EDUCATION/EXPERIENCE/TRAINING
Required:
• High school diploma required
• 3+ years of hospital (institutional) billing and/or account follow-up experience
• 1+ year of experience in a lead, supervisory, or team coordination role, or demonstrated ability to coach and direct the work of others

Preferred:
• Associate or Bachelor’s degree in healthcare administration, health information management, medical billing, or related field
• Epic certification in Resolute Hospital Billing and/or Claims
• Experience with HB Follow-Up denial and appeal workflows and tracking appeal outcomes
• Experience with Epic reporting tools (Reporting Workbench, SlicerDicer) for work queue and productivity monitoring
• Understanding of Medi-Cal billing requirements and regulations
• Experience with Independent Physician Association (“IPA”) and Health Plan relationships
• Certified Revenue Cycle Representative (CRCR) or Certified Professional Biller (CPB)