BFS is hiring a full time billing and coding manager. Our team of medical professionals serves families in both the inpatient and outpatient setting as well as provides classes as an in network benefit and our reach across the state is growing.  We are seaking an individual with experience in medical billing and excellent customer service skills.

This position is full time with:

  • Competetive Salary
  • 100% employee only medical benefits covered
  • 3 weeks of PTO plus 4 paid holidays
  • up to 3% employer matching for retirement
  • annual continuing educaton.

We are a passionate team of care providers serving a fragile population of newborns and breastfeeding or chestfeeding parents. We are excited to welcome you to our team.

Summary

Responsible for all aspects of the billing process for Breastfeeding Success. Performs a range of routine insurance processing for the following service types: outpatient, inpatient, telemed and classes. Responsible for weekly and monthly reporting activities such as preparation of various  summary insurance reimbursement reports and related financial reports for ongoing meetings. Also manages any and all insurance correspondence, including requests for medical records, refunds and correction of claims. Tracks average revenue per visit, as well as updating fee and allowable schedules. Has a deep understanding of compliance and insurance reimbursement best practices. Is proficient with spreadsheets and other software tools.  Reports directly to the Practice Manager and Co-CEOs. Has gained proficiency in multiple competencies relevant to the job. Works independently within established procedures associated with the specific job function. Typically requires 5+ years of related experience.

Duties and Responsibilities:

Insurance Claims Processing – managing all aspects related to insurance claims; independent decision-making and direct contact with insurance carriers from beginning to resolution.

  • Prepare and electronically submit insurance claims in a timely manner; expectation is to submit claims within three to five days of date of service unless there is a business need to delay billing
  • Resolve rejected claims with insurance providers
  • Report to Practice Manager, Co-CEOs and Chief Strategy Officer (“Executive Team”) on a weekly basis to provide key insight into collection and billing practices
  • Coordinate with external accounting team to correctly account for all claims collections and deposits
  • Ensure patient obtains any required authorizations from PCP; work alongside Administrative Assistants on referral and authorization process

Accounts Receivable: Managing all aspects of client and insurance Accounts Receivable department; independent decision-making regarding Accounts Receivable projects and goals

  • Monitor aged Accounts Receivable and resolve unpaid claims
  • Direct and independent follow up with clients for collection of direct pay, “private pay”, co-pay and coinsurance amounts
  • Credit card processing and posting 
  • Weekly preparation and presentation to the Executive Team of detailed Accounts Receivable reports and analysis of key metrics
  • Develop recommendations for process improvements to reflect best practices and achieve operational goals
  • Responsible for handling any and all patient billing questions for all service types including breast rental pumps and scales

Cash and payment posting:

  • Ensures bank deposits by Administrative Assistants is in balance
  • Posting and reconciliation of EOBs in billing system, with adjustments and write-offs as appropriate
  • Responsible for setting up any portals for EFT setup, EOB retrievals and insurance refunds/offsets from future claims

Position Requirements:

  • Bachelor’s Degree
  • At least 5 years of insurance claim processing experience; Athena experience required
  • Proficient with Excel spreadsheet analysis
  • Detail Oriented
  • Ability to work independently without direct daily supervision 
  • Remote position with periodic onsite executive meetings and/or staff training

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