Supervisor Business Services: Business Service-Managed Care

Hoag•Costa Mesa, CA

58d

About The Position

The Business Services Supervisor provides leadership and oversight for the Government Billing team, which manages both Medicare and Medi-Cal accounts. This role is responsible for supervising billing and collections operations, ensuring compliance with federal and state regulations, and driving team performance to achieve revenue cycle goals. The Supervisor manages staff performance, training, and development, and serves as the primary escalation point for complex claim, payer, or patient issues. By collaborating with internal departments and external partners, the Supervisor ensures accurate and timely claim resolution, supports process improvements, and upholds the highest standards of quality and compliance.

Requirements

High school diploma or equivalent required.
Three (3) years’ experience in hospital Revenue Cycle required.
Government Billing and Collecting: Three years’ experience in hospital AR management and Medicare and medi-Cal, PPO/HMO claim adjudications required.
Experience in all phases of billing and working knowledge of federal and state regulations and requirements related to Medicare billing.

Nice To Haves

Two years of supervisory experience preferred.
Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) certifications

Responsibilities

Provides day to day supervision of the Government Billing team, ensuring coverage for both Medicare and Medi-Cal operations.
Oversees billing and collections processes, including claim submission, corrections, follow-up, and appeals.
Monitors workqueues and system reports to ensure timely resolution of government accounts.
Reviews and distributes workload assignments based on claim type, dollar value, and team capacity.
Ensures compliance with federal and state regulations, including Medicare and Medi-Cal billing rules.
Partners with internal departments such as Coding, Registration, and Revenue Integrity to resolve account barriers.
Provides coaching, training, and mentorship to staff, fostering accountability and professional growth.
Conducts regular performance reviews and delivers feedback to support employee development.
Oversees payer correspondence and underpayment reviews to ensure timely and accurate appeals.
Serves as a subject matter expert for complex claims, such as consecutive accounts, eligibility issues, and denial management.
Assigns and adjusts workloads to meet department productivity and quality assurance standards.
Tracks accounts receivable performance, backlog trends, and key financial metrics, reporting results to leadership.
Facilitates staff training sessions and department meetings to communicate updates and expectations.
Ensures accurate use of claim edits, adjustment codes, modifiers, and condition codes in compliance with CMS guidelines.
Develops staff cross-training between Medicare and Medi-Cal functions to build operational flexibility.
Responds to patient and payer escalations with professionalism, clarity, and resolution focused communication.
Collaborates with leadership to identify staffing needs, workflow efficiencies, and process improvements.
Escalates systemic or recurring issues to leadership and assists with developing long-term solutions.
Manages staff scheduling, time off requests, and coverage planning to maintain adequate service levels.
Participates in regulatory updates and translates new requirements into team training and workflow changes.
Drives continuous improvement initiatives by identifying inefficiencies and recommending solutions.
Performs other related duties as assigned.