Revenue Cycle Supervisor

Ketchikan Indian Community•Ketchikan, AK

1d•$32 - $48•Onsite

About The Position

The Revenue Cycle Supervisor is a working supervisor who oversees daily billing, claims, denial-management, and accounts-receivable operations across KIC service lines and billing systems. The position also performs direct production work, particularly complex denials, payer appeals, and high-dollar accounts-receivable follow-up. It supervises billing clerks, coding staff, and accounts-receivable personnel, ensuring timely and accurate claims and maximum reimbursement across Medicaid, Medicare, commercial insurance, IHS Purchased/Referred Care, VA, and other payers. The Supervisor coordinates closely with the Patient Access Supervisor to address handoffs between registration and eligibility verification and billing and collections. The role manages daily workflows and staff oversight, gathers performance data, identifies and escalates operational issues, and maintains compliance with applicable federal, state, and tribal requirements, including HIPAA, CMS guidelines, and IHS policies. The position must be sensitive to KIC’s purpose of serving Tribal members and to the cultural values of KIC’s Tribal members and AI/AN beneficiaries. The position is located at 306 Main St, Ketchikan, Alaska, and is listed as regular full-time, with a Monday–Friday, 8 a.m.–5 p.m. shift.

Requirements

High school diploma or equivalent.
At least two years of healthcare revenue-cycle operations experience, including direct experience in medical billing, claims processing, denial management, or accounts-receivable follow-up.
At least one year of lead, team-coordination, or demonstrated leadership responsibility in a healthcare setting.
Relevant experience, education, and training may substitute for education and experience requirements on a year-for-year basis.
Have or complete within 12 months of hire an approved professional development program relevant to healthcare revenue-cycle management, such as AAPC CPB or CPC certification, MGMA, or HFMA.
Strong understanding of and sensitivity to American Indian/Alaska Native Tribal culture and lifestyle, and ability to work effectively with AI/AN populations.
Knowledge of healthcare revenue-cycle processes from registration through collections, including charge capture, coding, claim submission, payment posting, denial management, and accounts-receivable follow-up.
Knowledge of multi-payer billing requirements, including Medicaid, Medicare, commercial insurance, VA/CHAMPVA, and IHS Purchased/Referred Care.
Knowledge of medical terminology and CPT, ICD-10-CM, CDT, and HCPCS coding systems sufficient to review claims and coordinate with coding staff.
Knowledge of HIPAA privacy and security requirements as applied to revenue-cycle operations.
Effective oral and written communication skills, including the ability to explain complex billing and payer issues to clinical staff, providers, and leadership.
Ability to use personal computers and varied software, including healthcare billing platforms, electronic health records, and clearinghouse systems.
Ability to supervise, coach, and develop staff in a professional healthcare environment.
Ability to analyze accounts-receivable aging reports, denial trends, and revenue-cycle performance data to identify problems and implement solutions.
Ability to establish and maintain cooperative working relationships with management, coworkers, and outside contacts.
Ability to maintain strict confidentiality and comply with federal and tribal privacy laws and KIC policies, including HIPAA and HITECH.
Ability to manage concurrent priorities and deadlines across billing systems and payer types, work independently and with teams, and adapt to changing priorities, systems, and payer requirements.
Proficiency in Microsoft Excel and basic reporting tools for data analysis and reporting.
Ability to maintain attention to detail in a high-volume, deadline-driven environment.
May be required to possess and maintain a valid driver's license or be capable of obtaining one, and to be insurable by KIC's company insurance.
Must adhere to KIC drug and alcohol policies and pass pre-employment and subsequent random and/or for-cause drug and alcohol screening.
For positions in a covered classification, employment offers are conditional on a federal criminal background check confirming eligibility under the P.L. 101-630 Indian Child Protection and Family Violence Protection Act.

Nice To Haves

Bachelor’s degree in healthcare administration, business, health information management, or a related field.
Five or more years of healthcare revenue-cycle experience with progressive responsibility.
Current CPB, CPC, CRCR, relevant MGMA certification, or equivalent.
Experience in tribal health, IHS, or FQHC revenue-cycle operations, including familiarity with Alaska Medicaid tribal encounter rate mechanics and the 100% FMAP pass-through for AI/AN beneficiaries.
Experience with Cerner Millennium, INSYNC, Dentrix, or comparable healthcare billing platforms.
Experience with denial-management analytics, root-cause analysis, and payer appeals.
Community-clinic experience and a strong commitment to multidisciplinary teamwork.

Responsibilities

Oversee daily claim submission across billing systems; assign and monitor work queues, track staff productivity, and ensure claims are accurate and submitted within payer-specific filing limits.
Personally resolve complex denials, payer appeals, and high-dollar accounts-receivable follow-up.
Monitor denial trends and root causes; track denial rates, overturn rates, and recovered amounts by payer and category, and report trends to the Revenue Cycle Director.
Establish and enforce accounts-receivable aging thresholds, monitor aging, and reassign work to address backlogs, prioritizing high-dollar accounts and claims nearing filing limits.
Ensure proper payer sequencing for AI/AN beneficiaries to maximize tribal encounter rate capture and 100% FMAP reimbursement.
Coordinate with Patient Access to resolve eligibility, registration, and insurance-capture issues affecting claims, and communicate collection barriers to the Revenue Cycle Director.
Supervise billing clerks, coding staff, and accounts-receivable personnel; provide coaching and cross-training, and conduct performance evaluations.
Develop and maintain written standard operating procedures for billing, denials, and accounts receivable; orient new staff to workflows, systems, and expectations.
Identify and report coding-related denials, coding lag times, and chart-closure delays; coordinate with coding staff and clinical departments as directed.
Gather and validate revenue-cycle data for performance reporting; identify and report revenue leakage and operational inefficiencies.
Document system issues, workflow inefficiencies, and billing errors across platforms, and escalate configuration and optimization needs.
Implement workflow and billing changes as directed in response to payer or regulatory updates.
Monitor claims held due to enrollment-related billing delays and flag incomplete provider enrollment issues for escalation.
Ensure billing and collections comply with applicable federal, state, and tribal regulations, including HIPAA, CMS guidelines, and IHS policies.
Maintain sensitivity to the cultural values of KIC Tribal members and the AI/AN beneficiary population.
Assign and reassign daily work across billing, denials, and accounts-receivable functions; enforce workflows, productivity expectations, and procedures.
Provide input on performance evaluations and recommend corrective actions.
Escalate policy changes, system issues requiring vendor or partner engagement, financial or strategic concerns, staffing structure decisions, and payer contract issues to the Revenue Cycle Director.
Perform other related duties as assigned.