What are the responsibilities and job description for the Revenue Cycle Billing Supervisor position at Acutis Diagnostics?
Job Summary- The RCM Billing Supervisor for Toxicology and Molecular Diagnostics is responsible for managing the end-to-end billing operations for specialized lab services. This includes overseeing claim submissions, denial management, payer compliance, and team performance. The role requires deep expertise in lab-specific CPT/HCPCS codes, payer policies, and evolving molecular testing regulations. Key Responsibilities- Billing Oversight -
- Supervise daily billing operations for toxicology (e.g., drug screening, confirmation testing) and molecular diagnostics (e.g., PCR, genetic testing).
- Ensure accurate charge capture and timely claim submission.
- Monitor clearinghouse rejections and resolve coding or modifier issues. Team Management -
- Lead and mentor billing staff; conduct training on lab-specific billing protocols.
- Develop SOPs for toxicology and molecular diagnostics billing workflows.
- Conduct performance reviews and support staff development. Denial & AR Management -
- Analyze denial trends (e.g., PR-55, CO-197) and implement corrective actions.
- Oversee AR follow-up and ensure timely resolution of unpaid or underpaid claims.
- Collaborate with payers and labs to resolve complex billing issues. Compliance & Quality -
- Ensure compliance with CMS, CLIA, and payer-specific lab billing guidelines.
- Stay current with changes in molecular diagnostics billing (e.g., PLA codes, NCDs).
- Conduct internal audits to ensure coding accuracy and documentation integrity. Reporting & Analytics -
- Track KPIs such as Clean Claim Rate, Denial Rate, and DSO.
- Generate monthly reports and present insights to leadership.
- Recommend process improvements based on data trends. Qualifications Education & Experience
- Bachelor’s degree or appropriate accreditation in Healthcare Administration, Business, or related field.
- 3–5 years of experience in lab billing, with at least 2 years in toxicology or molecular diagnostics.
- Prior supervisory experience in a healthcare billing environment. Skills & Knowledge
- Strong knowledge of CPT codes (e.g., 80305–80307, G0480–G0483, 814xx series).
- Familiarity with payer-specific rules for high-complexity lab testing.
- Prior Xifin experience is preferred.
- Proficiency in LIS, billing software, and clearinghouse platforms.
- Excellent leadership, communication, and analytical skills.