Description

The Billing Office Supervisor is responsible for overseeing the daily operations of the billing department for a busy multi-location Retina and Ophthalmology practice. This position manages all revenue cycle activities, including charge entry, claim submission, payment posting, denial management, accounts receivable follow-up, patient collections, and financial reporting. The supervisor will lead and develop billing staff while ensuring compliance with Medicare, commercial insurance carriers, and retina-specific coding and reimbursement guidelines.

The ideal candidate will have extensive experience in ophthalmology and retina billing, strong leadership skills, and a proven track record of improving revenue cycle performance and financial outcomes.

Essential Duties and Responsibilities

Revenue Cycle Management

Supervise all aspects of the revenue cycle from charge capture through final payment.
Monitor billing workflows to ensure timely claim submission and reimbursement.
Review and analyze aging reports, denial reports, rejection reports, and payment trends.
Develop and implement strategies to reduce Accounts Receivable (A/R) and improve cash collections.
Ensure timely follow-up on unpaid claims and appeals.
Oversee patient balance collection processes and payment arrangements.
Monitor reimbursement trends and identify opportunities for revenue enhancement.
Retina and Ophthalmology Billing Oversight

Maintain expertise in retina-specific coding, billing, and reimbursement regulations.
Ensure proper coding and billing for:
Intravitreal injections
Retina laser procedures
Vitrectomy procedures
Retinal detachment repairs
OCT imaging
Fluorescein angiography
Fundus photography
Visual field testing
Minor and major surgical procedures
Drug administration and biologic medications
Oversee billing and reimbursement for high-cost injectable medications including buy-and-bill inventory management.
Ensure compliance with Medicare Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), and payer-specific requirements.
Familiarity with funding programs that help our patients to receive care they need.
Financial Management and Reporting

Prepare and present monthly billing and financial performance reports.
Analyze key performance indicators (KPIs), including:
Days in A/R
A/R over 90 days
Net collection rate
Gross collection rate
Denial rate
First-pass claim acceptance rate
Charge lag
Payment lag
Patient collection percentages
Identify trends affecting practice revenue and recommend corrective actions.
Assist leadership with budgeting, forecasting, and financial planning related to revenue cycle operations.
Reconcile billing data and ensure accuracy of financial reporting.
Leadership and Staff Management

Supervise, train, mentor, and evaluate billing department personnel.
Conduct regular staff meetings and performance reviews.
Establish productivity and quality benchmarks for team members.
Ensure cross-training within the department to promote operational continuity.
Foster a culture of accountability, collaboration, and continuous improvement.
Compliance and Quality Assurance

Ensure compliance with HIPAA, CMS regulations, and payer requirements.
Conduct regular audits of billing and coding activities.
Maintain current knowledge of changes in coding, reimbursement, and regulatory requirements.
Collaborate with providers and clinical staff to improve documentation supporting accurate billing.
Collaboration and Communication

Work closely with physicians, administrators, clinical managers, and front desk leadership.
Provide education and support regarding billing policies and reimbursement issues.
Serve as the primary resource for complex billing and payer-related concerns.

Requirements

Qualifications

Required

Minimum 5 years of medical billing experience.
Minimum 3 years of supervisory or management experience.
Extensive knowledge of ophthalmology and retina billing practices.
Strong understanding of Medicare, Medicaid, and commercial payer regulations.
Experience managing Accounts Receivable and denial management programs.
Proficiency with practice management and electronic health record systems.
Advanced knowledge of CPT, ICD-10, HCPCS, and modifier usage.
Strong analytical and financial reporting skills.
Excellent communication and leadership abilities.
Preferred

Retina specialty billing experience.
Experience with multi-location physician practices.
Knowledge of inventory and reimbursement management for specialty pharmaceuticals and injectable medications.
Key Performance Expectations

Maintain A/R greater than 90 days below industry benchmarks.
Achieve first-pass claim acceptance rates above 95%.
Maintain denial rates below 5%.
Improve net collection rates and reduce claim turnaround times.
Ensure timely and accurate billing for all services rendered.
Provide monthly KPI reporting and actionable recommendations to leadership.
Physical Requirements

Ability to sit for extended periods while working on a computer.
Ability to communicate effectively with staff, providers, patients, and insurance representatives.
Occasional travel between clinic locations may be required.
Reports To

Practice Administrator
Supervises

Billing Specialists, Payment Posters, A/R Representatives, Collection Specialists, and other Revenue Cycle personnel.
Benefits:

401(k)
401(k) matching
Dental insurance
Flexible schedule
Flexible spending account
Health insurance
Health savings account
Paid time off
Retirement plan
Vision insurance
 
Work Location: In person