Revenue Cycle Billing Supervisor

FULGENT THERAPEUTICS LLC•Coppell, TX

22h•Onsite

About The Position

Inform Diagnostics, a Fulgent Genetics Company, is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology. Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a premier, full-service genomic testing company built around a foundational technology platform. Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can redefine the way medicine is managed for patients and clinicians alike. Since integrating with our therapeutic development business, Fulgent is also developing drug candidates for treating a broad range of cancers using a novel nanoencapsulation and targeted therapy platform. By merging our fields of expertise, we aim to become a fully integrated precision medicine company. Summary of Position The Revenue Cycle Billing Supervisor is responsible for overseeing front-end billing, pre-billing, claim readiness, and billing-related work queues for anatomic pathology and genetics laboratory services. This position will ensure charges and claims move accurately and timely through the Quadax Revenue Cycle Management system. The Supervisor will oversee the offshore pre-billing team, working closely with the Manager and Director, and will serve as a technical resource for front-end billing processes. This role will directly manage designated worklists and hold categories while monitoring other billing-related inventories to ensure accountability, timely resolution, and compliance with payer timely-filing requirements. This position will also lead the implementation and ongoing management of Quadax PAS pre-billing functionality for front-end eligibility verification and prior authorization screening.

Requirements

Minimum of three to five years of healthcare revenue cycle experience.
Minimum of two years of supervisory or team-lead experience.
Experience with laboratory billing, preferably anatomic pathology, molecular diagnostics, or genetics.
Experience with Quadax RCM strongly preferred.
Working knowledge of pre-billing, claim edits, eligibility verification, prior authorization, insurance discovery, clearinghouse rejections, and timely-filing requirements.
Experience supervising offshore or remote revenue cycle teams preferred.
Strong analytical, organizational, communication, and problem-solving skills.

Nice To Haves

Bachelor's degree in healthcare administration, business, finance, or a related field preferred.
Equivalent laboratory revenue cycle experience may be considered.

Responsibilities

Oversee all Quadax pre-billing activities for anatomic pathology and genetics laboratory services.
Supervise the offshore pre-billing team and establish clear productivity, quality, and turnaround-time expectations.
Partner with Manager and Director to provide technical and operational support for front-end billing processes.
Review charges and claims for billing readiness, including patient demographics, insurance information, ordering-provider information, diagnosis codes, procedure codes, authorization requirements, and supporting documentation.
Ensure claims are released from Quadax accurately and within established billing timelines.
Identify barriers preventing charges or claims from clearing the Quadax system and coordinate their resolution.
Lead the implementation of Quadax PAS pre-billing functionality, which is not currently established within the organization.
Develop workflows for front-end eligibility verification, benefit screening, and prior authorization validation.
Work with Quadax and internal stakeholders to define system requirements, work queues, edits, routing rules, and escalation processes.
Establish processes to identify services requiring prior authorization before claims are submitted.
Monitor PAS results and ensure unresolved eligibility or authorization issues are assigned, worked, documented, and escalated appropriately.
Directly manage assigned pre-billing worklists, billing holds, and held-charge inventories.
Monitor billing-related worklists and holds assigned to other teams to ensure timely follow-up and resolution.
Establish ownership, aging standards, escalation thresholds, and reporting requirements for each worklist and hold category.
Review aging inventories regularly to prevent unbilled claims from exceeding payer timely-filing requirements.
Escalate aged or high-risk inventory to revenue cycle leadership when resolution requires assistance from laboratory operations, client services, sales, credentialing, contracting, coding, or information technology.
Oversee the correction and completion of patient demographic and insurance information required for claim submission.
Manage insurance discovery workflows for patients with missing, incomplete, or invalid coverage information.
Ensure eligibility information is reviewed and documented before claims are released.
Coordinate with internal teams and vendors to resolve insurance identification, subscriber, coordination-of-benefits, and coverage-related issues.
Work directly with Quadax to establish a formal process for managing front-end claim rejections.
Ensure upfront rejections are assigned to the appropriate team and are no longer left unassigned or unresolved.
Monitor claims that have not cleared the Quadax system and establish daily follow-up requirements.
Identify claims at risk of exceeding payer timely-filing limits and prioritize them for immediate resolution.
Analyze rejection trends and implement corrective action to prevent recurring issues.
Partner with billing, coding, AR, EDI, IT, and Quadax representatives to resolve system, configuration, claim-edit, and clearinghouse issues.
Provide daily oversight, coaching, training, and technical support to the pre-billing team.
Monitor individual and team productivity, quality, aging, and turnaround time.
Conduct regular quality audits and provide documented feedback.
Develop standard operating procedures, job aids, workflow documentation, and training materials.
Ensure staff consistently document account activity and follow established escalation procedures.
Address performance concerns and develop corrective action plans when necessary.
Prepare and distribute reports covering unbilled charges, held claims, front-end rejections, eligibility issues, authorization issues, insurance discovery, worklist aging, and timely-filing risk.
Conduct routine inventory reviews with leadership and operational stakeholders.
Track root causes of billing delays and recommend workflow or system improvements.
Support month-end billing goals and ensure high-priority inventory is resolved before established deadlines.
Participate in meetings with Quadax and internal stakeholders regarding billing operations, system configuration, and workflow improvements.
Ensure billing processes comply with federal and state regulations, payer requirements, laboratory billing policies, and organizational procedures.
Maintain controls to prevent inaccurate billing, duplicate claims, unsupported charges, and untimely submissions.
Ensure appropriate documentation is available to support billed laboratory services.
Protect patient information and maintain compliance with HIPAA and organizational privacy requirements.