Hospital Billing Supervisor | Revenue Cycle

Guidehouse•San Antonio, TX

About The Position

The Hospital Billing Supervisor – Revenue Cycle oversees the daily operations of the hospital billing team to ensure timely, accurate, and compliant submission of facility claims. The supervisor provides day-to-day leadership and technical guidance to billing staff; monitors productivity and quality; manages claim edits, billing holds, and related work queues; and works with internal departments, payers, and clearinghouses to resolve issues delaying claim submission or reimbursement. The role is accountable for meeting billing goals and client service-level expectations while complying with federal and state regulations, payer requirements, and organizational policies. The supervisor supports staff development, communicates operational issues and recommendations to management, and identifies billing trends and opportunities to improve processes. Responsibilities include overseeing claim generation, review, correction, release, and reconciliation; monitoring rejections and billing exceptions; conducting or coordinating quality reviews; maintaining performance reporting; supporting audits and corrective actions; and collaborating on system and workflow changes.

Requirements

Bachelor’s degree and a minimum of five years of relevant experience, or a high school diploma and seven years of relevant experience.
A minimum of two years of leadership, supervisory, or people-management experience.
Hospital/facility billing or Patient Financial Services experience.
Strong understanding of hospital revenue cycle operations and accounts receivable.
Working knowledge of government and commercial payer billing requirements.
Demonstrated experience managing billing inventories, claim edits, claim holds, rejections, and/or billing-related work queues.
Strong analytical, organizational, communication, and problem-solving skills.
Ability to manage competing priorities and make timely operational decisions.
Ability to communicate effectively with staff, management, clients, payers, and cross-functional departments.

Nice To Haves

Extensive hospital billing experience.
Experience with Epic Hospital Billing (HB), Meditech 6, and/or Meditech Magic.
Experience managing claim edit and billing work queues.
Knowledge of Medicare and Medicaid hospital billing requirements.
Familiarity with CPT, HCPCS, ICD-10, revenue codes, claim forms, and hospital reimbursement methodologies.
Experience with billing scrubbers, clearinghouses, electronic claim submissions, and payer portals.
Experience developing or monitoring hospital billing KPIs and productivity standards.
Intermediate to advanced Microsoft Excel skills.
Strong client-service and cross-functional collaboration skills.

Responsibilities

Provide daily leadership, direction, coaching, and support to hospital billing staff; establish expectations and monitor individual and team performance.
Train staff on billing requirements, payer updates, regulatory changes, and departmental procedures; conduct team meetings and escalate staffing, performance, compliance, or operational concerns when appropriate.
Oversee hospital claim billing activities, including claim generation, review, correction, release, and reconciliation, to support timely and accurate clean-claim submission.
Monitor work queues, claim edits, billing holds, unbilled accounts, electronic submissions, payer rejections, clearinghouse edits, and billing exceptions through resolution.
Ensure staff resolve claim edits appropriately, route accounts to the correct department when needed, and document actions accurately in the patient accounting system.
Oversee corrected, replacement, and adjusted claim workflows, and research and escalate billing issues as necessary.
Collaborate with payers, clearinghouses, internal departments, and other stakeholders to resolve recurring billing issues and develop corrective action plans.
Monitor billing accuracy, claim quality, productivity, timeliness, inventory aging, and key performance indicators; identify trends, backlogs, and performance gaps.
Develop action plans to reduce billing delays, avoid rework, and address root causes of recurring edits, rejections, and process failures.
Perform or coordinate quality reviews and ensure adherence to billing procedures, prioritization, and aging expectations.
Serve as an escalation point for complex billing issues and collaborate with Patient Access, Health Information Management, Coding, Utilization Management, Revenue Integrity, IT, and other revenue cycle departments.
Communicate payer billing changes and requirements to staff and affected departments; work with IT and system support teams on issues affecting claim accuracy or timeliness.
Support implementation and testing of system or workflow changes affecting hospital billing.
Ensure billing activities comply with applicable regulations, payer requirements, and organizational policies; educate staff on billing practices and compliance expectations.
Identify potential billing or compliance concerns and escalate them to management and appropriate compliance resources; support audits and corrective actions.
Prepare, review, and distribute daily, weekly, and monthly billing reports, including reports on productivity, turnaround time, unbilled accounts, claim holds, edits, rejections, quality, and staff performance.
Provide management with updates on significant billing barriers, backlogs, payer issues, trends, and operational risks; complete required reports, reconciliations, and projects accurately and on time.
Evaluate workflows, develop or maintain standardized procedures and training materials, encourage staff input, and support new technologies, payer requirements, system enhancements, and revenue cycle initiatives.