Job Description
Job Details: Level: Experienced,
Job Location: IDX Coppell TX Site - Coppell, TX 75019,
Position Type: Full Time, Education Level: 2 Year Degree,
Job Category: Biotech, About Us
Inform Diagnostics, a Fulgent Genetics Company, is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology.
Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a premier, full-service genomic testing company built around a foundational technology platform.
Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can redefine the way medicine is managed for patients and clinicians alike.
Since integrating with our therapeutic development business, Fulgent is also developing drug candidates for treating a broad range of cancers using a novel nanoencapsulation and targeted therapy platform. By merging our fields of expertise, we aim to become a fully integrated precision medicine company.
Summary of Position
The Revenue Cycle Management Supervisor oversees accounts receivable (AR) follow-up, denials, appeals, and collections for anatomic pathology and genetics laboratory services in the Quadax revenue cycle management (RCM) system. As technical lead for senior collectors and the collections team, the Supervisor ensures effective follow-up, accurate documentation, and timely claim resolution. The Supervisor manages designated worklists and holds, monitors assigned inventories, and sets ownership, follow-up, and escalation standards.
Working with the Revenue Cycle Management Manager, the Supervisor trains and coaches staff, audits accounts, tracks key performance indicators (KPIs), and identifies payment barriers. The Supervisor partners with billing, coding, and operational leaders to improve appeals, prevent recurring nonpayment, and increase reimbursement.
Key Job Elements
Accounts Receivable and Worklist Oversight
- Manage designated Quadax collections worklists, holds, and held-charge inventories, and monitor all others through resolution.
- Assign every worklist an owner, follow-up expectations, aging standards, and escalation procedures.
- Verify daily follow-up advances claims toward resolution and is prioritized by aging, reimbursement opportunity, and payer filing or appeal deadlines.
- Address repetitive account activity, duplicate appeals, unsupported resubmissions, and recurring unresolved issues.
- Work with the Revenue Cycle Management Manager to balance workloads, clear backlogs, and prioritize high-risk or high-value accounts.
Denial Management and Reimbursement Improvement
- Oversee denial research, corrective action, appeals, and payer follow-up for anatomic pathology and genetics claims.
- Analyze nonpayment trends by payer, denial reason, service, and workflow to identify recurring barriers.
- Identify demographic, eligibility, authorization, coding, submission, and payer policy issues, and coordinate corrective action with responsible teams.
- Ensure appeals address the denial reason and include supporting documentation, submission confirmation, and follow-up.
- Monitor appeal outcomes and overturn rates to improve appeal quality.
- Escalate systemic payer issues with account examples, financial impact, and recommended next steps.
- Track corrective actions to completion and verify the underlying payment issue is resolved.
Technical Leadership, Training, and Performance Management
- Guide senior collectors and the team on complex claims, payer requirements, Quadax workflows, and escalations.
- Train and coach staff using production results, quality reviews, denial trends, and knowledge gaps.
- Hold weekly one-on-ones to review KPIs, production, quality, barriers, and action items. Monitor adherence to productivity, quality, follow-up, and documentation standards.
- Partner with the Revenue Cycle Management Manager to address performance concerns and track improvement.
Quarterly Collections Audits
- Conduct documented quarterly audits of the collections team using a consistent review process.
- Assess root-cause identification, corrective action, and required follow-up. Check first-touch resolution where feasible and verify documented next steps and follow-up dates on unresolved accounts.
- Review appeal quality, payer responses, claim corrections, adjustment requests, and supporting documentation.
- Identify ineffective activity, such as repetitive notes, unnecessary resubmissions, and repeat appeals without payer follow-up. Review findings with each collector, assign corrective actions, and verify improvement through targeted reviews.
AR Reviews and Reporting
- Lead biweekly AR reviews with the Revenue Cycle Management Manager for assigned NCS and genetics testing portfolios.
- Present aging trends, reimbursement results, major denials, appeal outcomes, payer barriers, and accounts needing escalation.
- Track action owners, deadlines, and progress between meetings.
- Use advanced Excel to analyze large datasets, reconcile inventories, and identify collection and reimbursement opportunities.
- Report worklist performance, unresolved inventory, and timely-filing and appeal risks, with recommendations supported by account examples and financial impact.
Adjustment Review and Controls
- Review adjustment and write-off requests that exceed collectors' authority. Validate the adjustment reason, supporting documentation, account history, and prior collection efforts.
- Approve requests within delegated authority; route others to the Revenue Cycle Management Manager or designated leader.
- Monitor adjustment trends to identify preventable revenue loss, training needs, and payer or workflow issues.
Escalation Management
- Serve as first supervisory contact for escalated billing and collections inquiries from patients, clients, sales representatives, and internal teams.
- Coordinate escalated medical-record requests, payer audits, and related documentation with the appropriate departments.
- Document and assign each escalation, and resolve it within established turnaround expectations.
- Escalate issues requiring management, compliance, contracting, or clinical review, and track them to resolution.
Workflow Documentation and Portal Access
- Maintain collections SOPs, workflows, quick-reference guides, and desktop references, and keep them current with payer requirements and Quadax workflows.
- Document payer-specific nonpayment trends, research findings, and approved corrective actions.
- Communicate process changes and ensure staff are trained.
- Maintain a portal inventory of users, access status, administrators, and enrollment or renewal requirements under organizational security policies.
Cross-Functional Collaboration
- Coordinate account resolution across billing, coding, and supervisory teams to prevent siloed workflows.
- Share denial findings, payer updates, audit results, and workflow changes with affected teams.
- Set clear handoffs and accountability for issues requiring action outside collections.
- Escalate emerging nonpayment trends to leadership quickly and collaborate on corrective action. Complete special projects and other duties as assigned.
Qualifications: Knowledge/Experience
- Associate degree, or at least four years of leadership or supervisory experience in lieu of a degree.
- Laboratory revenue cycle management experience, preferably in anatomic pathology, molecular diagnostics, or genetics.
- At least two years of denial management experience, including nonpayment research, root-cause analysis, corrective action, and resolution monitoring.
- Expert Excel skills, including pivot tables, advanced formulas, lookups, and reconciliation of large AR and payer datasets.
- Advanced ability to write and document SOPs, workflows, desktop references, and payer nonpayment trends.
- Ability to train and coach collectors, audit accounts, assess productivity and quality, and communicate performance expectations.
- Strong analytical, organizational, communication, and problem-solving skills.
Additional Skills
- Quadax RCM experience.
- Collections and AR management experience in high-volume laboratory operations.
- Experience resolving commercial and government insurance claims.
- Experience writing payer-specific appeals supported by claim details, payer requirements, and documentation.
Key Performance Indicators
- Collections and reimbursement performance against goals. Reduction in aged AR and unresolved worklist inventory.
- Appeal success and denial overturn rates. Denial resolution turnaround time and repeat denial rates.
- Meaningful account resolution, including first-touch resolution when feasible.
- Compliance with payer filing, appeal, and follow-up deadlines. Individual and team productivity and audit quality scores.
- Completion of weekly one-on-ones, quarterly audits, and biweekly AR reviews.
Supervisory Responsibilities
Reports To
- Revenue Cycle Management Manager/Director
Environment
Fulgent Therapeutics LLC is an Equal Employment Opportunity Employer.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. The term “qualified individual with a disability” means an individual with a disability who, with or without reasonable accommodation, can perform the essential functions of the position.
Please note that Fulgent (and its affiliated companies, including Inform Diagnostics and CSI Laboratories) does not accept unsolicited information and/or resumes from search firms or agencies for our job postings. Search firms or agencies without an applicable contract and/or express approval to recruit for the role in question — that choose to submit a resume or client information to our career page or to any employee of Fulgent — will not be eligible for payment of any fee(s), and any associated shared data will become the property of Fulgent.