Reimbursement Supervisor – Back End
NAVERIS
full-time
Posted on:
Location Type: Remote
Location: Remote • Massachusetts, North Carolina • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Oversee claims follow-up, appeals workflows, payer escalations, and compliance to ensure timely and accurate reimbursement
- Supervise, coach, and train appeals and back-end reimbursement specialists; monitor daily workflows and productivity to ensure adherence to procedures and quality standards
- Serve as an escalation point for complex billing issues, payer disputes, and escalated patient or provider inquiries
- Partner with internal teams and the outsourced RCM vendor to resolve discrepancies and improve reimbursement outcomes
- Assist in developing, documenting, and refining back-end reimbursement policies and procedures
- Ensure compliance with all applicable billing regulations and company policies, including HIPAA; conduct audits to identify trends, errors, and improvement opportunities
- Recommend process improvements to enhance efficiency, productivity, and cash flow
- Stay current on payer policies, coding updates, and federal/state regulations through ongoing education
- Communicate clearly with patients and providers regarding EOBs, appeals status, financial responsibility, and reimbursement policies in escalated cases
- Critically assess complex situations and escalate to leadership when appropriate
- Maintain a strong understanding of the end-to-end reimbursement lifecycle and communicate effectively across teams
- Leverage systems, tools, and vendor resources to support back-end reimbursement activities
- Manage multiple priorities and operate with urgency in a fast-paced environment
Requirements
- 4+ years of experience in reimbursement or revenue cycle management within a diagnostics company, laboratory, or commercial payer environment
- Bachelor’s degree or equivalent experience
- Prior experience supervising or leading a reimbursement or appeals team
- Experience with Xifin, Quadax, or Telcor preferred
- Strong understanding of medical benefit structures, including Federal, State, PPO, HMO, and indemnity plans
- Working knowledge of CPT, ICD-10, and HCPCS coding, as well as LCD/NCD coverage and reimbursement guidelines
- Demonstrated ability to identify process gaps, improve workflows, and ensure follow-through
- Excellent verbal and written communication skills with a strong customer service mindset
- Strong troubleshooting, organizational, and time-management skills
- Ability to adapt to evolving business needs
- Self-starter with the ability to work independently while supervising others
Benefits
- Competitive compensation
- Work/life balance
- Remote work opportunities
- Comprehensive medical coverage
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
reimbursementrevenue cycle managementCPT codingICD-10 codingHCPCS codingLCD coverageNCD coverageprocess improvementauditingbilling regulations
Soft skills
supervisioncoachingtrainingcommunicationtroubleshootingorganizational skillstime-managementadaptabilitycustomer servicecritical assessment