Revenue Cycle Billing Supervisor

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 labspecific 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., PR55, CO197) and implement corrective actions.
• Oversee AR followup 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 payerspecific 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.
• 35 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., 8030580307, G0480G0483, 814xx series).
• Familiarity with payerspecific rules for highcomplexity lab testing.
• Prior Xifin experience is preferred.
• Proficiency in LIS, billing software, and clearinghouse platforms.
• Excellent leadership, communication, and analytical skills.

About Acutis Diagnostics Inc

Acutis is a specialized medical laboratory that complements hard science with a service-first mindset. We are a growing clinical laboratory headquartered in Hicksville, NY. We pride ourselves on providing expert, accurate and concise results as a product of our highly talented and passionate team of professionals. We believe the team we build today will be the foundation of our future success.