Medical Records Biller V-Supervisor

Koniag Government Services, LLC•Oklahoma City, OK

1d•Hybrid

About The Position

Koniag Advisory Business Solutions, LLC, a Koniag Government Services company, is seeking a Medical Records Biller V-Supervisor to support KABS and our government customer in Oklahoma, OKC. This position requires the candidate to be able to obtain a Public Trust. This position is covered under the Service Contract Act. We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, paid holidays, paid Vacation, paid sick leave and more. Join Our Team Where Precision, Integrity, and Leadership Matter. 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.

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 the Indian Health Service (IHS), as a condition of access to IHS facilities, systems, and data.
Employment is contingent upon successful completion of all credentialing, fingerprinting, identity proofing, and security processing required by IHS and any other authorized government offices.
You must also be able to comply with all applicable medical privacy, records confidentiality, and IT security requirements governing access to patient information and federal systems.
In this role, you must adhere to HIPAA, HITECH, the Privacy Act, and all IHS privacy and security policies and procedures.
Maintain a dedicated, secure home office workspace.
Maintain a reliable high-speed internet connection.
Reside within a reasonable commuting distance of Oklahoma City.

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.
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.
Telework may be suspended or revoked at any time if privacy, security, operational, or contractual concerns arise.
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.