Medical Records Biller V-Supervisor

Koniag Government Services•Oklahoma City, OK

2d•Hybrid

About The Position

Koniag Advisory Business Solutions (KABS) is seeking an experienced, highly skilled Medical Biller V (Supervisor) to lead a billing team supporting a large-scale healthcare mission serving hospitals and clinics. This is a key leadership role responsible for billing quality, workflow oversight, denials management, and day-to-day supervision of Medical Biller IV (Lead) and Medical Biller III staff. In this role, you will combine expert technical billing knowledge with operational leadership. You will oversee billing production, support complex claim resolution, guide appeals and audit response, coordinate team workload, and help ensure the overall Alternate Resources billing function remains compliant, timely, and effective. This is a hybrid position based in Oklahoma City, Oklahoma. We anticipate July 1 as the project kick-off date. During the first few weeks of onboarding and initial training, employees are required to work on site full-time, Monday through Friday, 8:00 a.m. to 5:00 p.m. CT, at 701 Market Dr, Oklahoma City, OK 73114. Core working hours are generally 9:00 a.m. CT to 3:00 p.m. CT, with exact start and end times determined by the Program Manager. Work hours may flex based on client needs. Based on demonstrated proficiency and successful performance in all areas of responsibility, employees may become eligible for telework. Telework is a temporary privilege and may be modified or rescinded at any time due to operational, client, business, or security requirements. Maintain a dedicated, secure home office workspace. Maintain a reliable high-speed internet connection. Reside within a reasonable commuting distance of Oklahoma City. Report to the office at least twice every two weeks, and more often as needed for meetings or business requirements. The Medical Biller V (Supervisor) oversees and performs advanced billing, claims management, account follow-up, verification, and denial-resolution functions for outpatient and inpatient third-party claims. This role serves as the supervisory lead for billing operations and is responsible for team performance, workflow prioritization, quality oversight, escalation management, payer issue resolution, reporting, staff coaching, and operational continuity across the billing function.

Requirements

High school diploma or equivalent plus 8+ years of progressively responsible medical billing, claims processing, patient accounts, or revenue cycle experience; or an associate’s or bachelor’s degree in Health Information Management, Medical Billing and Coding, Business, or related field with 5+ years of progressively complex experience.
Expert knowledge of outpatient and inpatient billing, denial management, payer requirements, accounts receivable processes, UB-04 and CMS-1500 claim preparation, and reimbursement workflows.
Strong understanding of ICD, CPT, and HCPCS coding as used in billing support functions.
Demonstrated supervisory, team lead, or formal mentoring experience in a billing, patient accounts, or revenue cycle environment.
Experience with audits, appeals, post-payment review response, reporting, workflow oversight, and process improvement.
Proficiency with EHRs, RPMS or comparable systems, billing platforms, and productivity/reporting tools.
Strong analytical, organizational, leadership, and communication skills.
Must be able to obtain and maintain a favorable Tier II background investigation determination, as required by IHS.
Must successfully complete all required fingerprinting, identity proofing, credentialing, badge, and access steps.
Must complete required privacy, HIPAA, and IT security training within required timeframes and maintain current status thereafter.
Must comply with all IHS, HHS, facility, and company privacy, confidentiality, records management, and cybersecurity requirements.
Must protect PHI and other sensitive information in both paper and electronic form using required administrative, technical, and physical safeguards.
Must immediately report suspected privacy breaches, improper disclosures, security incidents, malware events, lost devices, or unauthorized access.
Must use only authorized systems, accounts, devices, software, and remote-access methods.
Must maintain workstation, password, and badge security at all times.
Must be able to support periodic access reviews, audits, and compliance checks.
If telework is approved, the employee must maintain a dedicated, private workspace suitable for handling confidential information and must use only authorized equipment, approved connections, and secure access methods.
Final candidates will be required to provide documentation and information necessary to support background investigation, credentialing, and access processing, which may include: Government-issued identity documents for identity proofing. Information needed for fingerprinting and background investigation processing. Current address and prior residence history, as requested. Employment history and related verification information, as requested. Professional certification and training documentation, as required. Any other forms or supporting materials required by IHS, HHS, or authorized security officials.

Nice To Haves

Completion of an accredited Medical Billing, Medical Coding, Health Information Management, or related program preferred.
Experience working in Indian Health Service.
Experience supervising billing operations in hospital, clinic, multi-site, or federal healthcare settings.
Expertise in Medicare, Medicaid, and commercial insurance billing requirements, reimbursement practices, and appeals processes.
Ability to mentor new staff and build cohesive working relationships across teams.
Familiarity with HIPAA regulations and healthcare compliance.
Possess sufficient initiative, interpersonal relationship skills, and social sensitivity such that he/she can relate constructively to Native American communities.

Responsibilities

Directly supervises billing staff, including Medical Biller IV (Lead) and Medical Biller III personnel, while maintaining hands-on responsibility for complex billing work.
Oversees the accurate and timely preparation and submission of outpatient and inpatient claims to third-party payers, intermediaries, and responsible parties.
Monitors daily claim inventory, export queues, productivity reporting, and aging issues to ensure work is completed within policy timeframes.
Oversees responses to post-payment reviews, exclusions, denials, appeals, and medical reviews and ensures appropriate supporting documentation is assembled.
Reviews unbillable claims, identifies recurring barriers to billing, and implements corrective actions or escalations.
Ensures electronic billing transmissions are HIPAA compliant, reconciliation processes are completed, and recurring errors are addressed at the process level.
Promotes continuing education, policy awareness, and self-development across the billing team.
Oversees qualitative and quantitative review of records to confirm diagnoses, provider signatures, attestation requirements, dates of service, and other documentation required to support compliant billing.
Serves as the senior escalation point for documentation discrepancies, eligibility issues, and payer-related verification problems.
Guides staff in obtaining authorizations, release forms, benefits assignments, and pre-certification materials needed for claims processing.
Coordinates with providers, benefits staff, utilization review, admitting, and other departments to resolve problems before claims are transmitted.
Ensures appropriate referrals are made to Benefits Coordination or Social Services when patients may qualify for additional coverage resources.
Oversees review of patient records, claim forms, coding-related billing data, E&M support, and inpatient and outpatient billing workflows.
Validates that UB-04, CMS-1500, and other required claim forms accurately reflect services rendered and meet payer and internal control requirements.
Leads denial management, rebilling, correction of rejected or suspended claims, and appeal support for complex accounts.
Monitors inpatient census, ADT-related workflow issues, and utilization-review coordination affecting billing and reimbursement.
Maintains oversight of account documentation, message-field activity, and status tracking in RPMS or other approved systems.
Supports establishment of day-to-day billing procedures, files, tickler systems, and status controls and recommends process improvements to management.
Ensures special projects and reporting assignments are completed within required timelines.
Maintains senior-level communication with payer organizations, fiscal intermediaries, agency personnel, and facility leadership to resolve difficult billing and systems issues.
Supports compliance with requirements governing use of funds collected from third-party insurance under the Indian Health Care Improvement Act and related policy.
Responds to ad hoc data and reporting requests and guides staff in use of approved search strategies and system identifiers.
Determines when reconstruction of data, reruns, restart actions, or other system interventions are necessary to support billing operations.
Provides day-to-day supervision, coaching, workload assignment, and performance feedback to Medical Biller IV and Medical Biller III staff.
Oversees productivity, timeliness, quality, and compliance across the billing team and escalates staffing or performance concerns as needed.
Acts as the primary point of contact for complex claims-processing questions, recurring operational issues, and leadership inquiries.
Recommends and helps implement changes in billing methods, procedures, information dissemination, and process controls to improve outcomes.
Maintains confidentiality of Alternate Resources claims and medical records and ensures staff comply with disclosure limits and safeguard requirements under IHS policy.