Reimbursement Supervisor - Back End

Naveris•Waltham, MA

1d•Remote

About The Position

We are looking for a conscientious, knowledgeable Reimbursement Supervisor – Back End to join our team and oversee post-submission reimbursement activities. While Naveris partners with an outsourced RCM vendor, this role provides hands-on oversight of claims follow-up, denials management, and appeals to ensure accurate reimbursement across Medicare, Medicaid, and commercial payers. This position plays a key role in driving timely resolution, compliance, and cash flow optimization.

Requirements

4+ years of experience in reimbursement or revenue cycle management within a diagnostics company, laboratory, or commercial payer environment
Bachelor’s degree or equivalent experience
Prior experience supervising or leading a reimbursement or appeals team
Strong understanding of medical benefit structures, including Federal, State, PPO, HMO, and indemnity plans
Working knowledge of CPT, ICD-10, and HCPCS coding, as well as LCD/NCD coverage and reimbursement guidelines
Demonstrated ability to identify process gaps, improve workflows, and ensure follow-through
Excellent verbal and written communication skills with a strong customer service mindset
Strong troubleshooting, organizational, and time-management skills
Ability to adapt to evolving business needs
Self-starter with the ability to work independently while supervising others

Nice To Haves

Experience with Xifin, Quadax, or Telcor preferred

Responsibilities

Supervise, coach, and train appeals and back-end reimbursement specialists; monitor daily workflows and productivity to ensure adherence to procedures and quality standards
Oversee claims follow-up, denials management, and appeals processes across all payer types
Serve as an escalation point for complex billing issues, payer disputes, and escalated patient or provider inquiries
Partner with internal teams and the outsourced RCM vendor to resolve discrepancies and improve reimbursement outcomes
Assist in developing, documenting, and refining back-end reimbursement policies and procedures
Ensure compliance with all applicable billing regulations and company policies, including HIPAA; conduct audits to identify trends, errors, and improvement opportunities
Recommend process improvements to enhance efficiency, productivity, and cash flow
Stay current on payer policies, coding updates, and federal/state regulations through ongoing education
Communicate clearly with patients and providers regarding EOBs, appeals status, financial responsibility, and reimbursement policies in escalated cases
Critically assess complex situations and escalate to leadership when appropriate
Maintain a strong understanding of the end-to-end reimbursement lifecycle and communicate effectively across teams
Leverage systems, tools, and vendor resources to support back-end reimbursement activities
Manage multiple priorities and operate with urgency in a fast-paced environment
Fully remote role (U.S.-based) with occasional travel for trainings, meetings, or on-site presence at headquarters.
Travel requirement: up to 5%.