Billing Lead

Job Type

Full-time

Description

ONSITE POSITION IN BRANDON, FL

At Florida Eye Specialists and Cataract Institute, a Sight360 company, we believe sight is our most important sense. It is a priceless gift that goes far beyond how you see the world. Sight is how we move through life, enjoy its wonders and form the memories that define us. That is why we are dedicated to caring for our patient’s sight every day.

We’ve assembled the most capable and credentialed multidisciplinary teams across every specialty of vision health – ophthalmology, optometry and optical retail services – to deliver a complete, 360-degree approach to vision care. One seamless patient experience. While we do share a single medical record that allows us to collaborate and coordinate care across all locations and providers, more importantly, we share a common belief and set of principles that guide us as we care for our patients.

That’s the Sight360 difference!

Requirements

The Billing Lead is responsible for managing the daily workflow of the Revenue Cycle Management team which may include authorizations, billing, coding and other resources. This includes managing billing workflows, supporting staff performance, and ensuring accurate, compliant, and timely processing of claims.

Essential Functions And Responsibilities

• Processes billing to patients and third-party insurance companies.
• Evaluates patient’s financial status and establishes budget payment plans
• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers, and reviewing past due accounts
• Assist the Billing Manager in overseeing the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management
• Serves as the subject matter expert and go to person for coding and billing processes
• Prepares and analyzes reports, and weekly and monthly financial reports to review with the Billing Manager
• Provides training for new and existing RCM staff on applicable operating policies, protocols, systems and procedures, standards, and techniques
• Performs an internal audit for the verification of practitioners coding accuracy
• Reviews and makes recommendations on appealed provider claims and makes determinations for appeals & grievances from members
• Maintains library of information/tools related to documentation guidelines and coding.
• Other duties as assigned by the Billing Manager
  
  

Supervisory Responsibility

• Position reports to Billing Manager or designee
• May be responsible for managing RCM resources as directed by Billing Manager or designee
  
  

Position/Type/ Expected Hours Of Work

• This is a full-time onsite position and core hours of work and days are Monday through Friday 8:00 a.m. to 5:00 p.m.
• Potential for evening and weekend hours as required.
  
  

Travel

Travel may be required to support the need to attend business meetings and/or training.

Qualifications

• Bachelor’s degree in a relevant area of expertise such as business or finance. Relevant skills, competencies, and experience may be considered in lieu of a degree.
• Medical Billing Coder Certification preferred.
• 3 years in a supervisory role in AR, RCM or relevant area of expertise within a healthcare organization demonstrating successful team leadership
• Experience leading cross-org discussions and working with a matrixed team of stakeholders to achieve common goal.
• Financial management skills including the ability to financially analyze data for operations, auditing, and forecasting; basic accounting knowledge; A/R and reserve analysis; and staffing and financial reporting skills.
• Extensive knowledge on critical business processes, primarily Insurance Authorizations, Billing, Collections, Dispute and Denial
• Management including working with out of network claims, claim submission requirements, and compliance for all payers.
• Current and in-depth knowledge of all Federal and State regulations related to billing and insurance
• Prior experience with accounting and/or EMR systems implementation
  
  

Skills And Abilities

• Ability to work independently within a start-up environment
• Interpersonal skills necessary to communicate vision and leadership to employees and other stakeholders
• Strong negotiation and facilitation skills to effectively influence change
• Analytical skills to interpret financial data and make recommendations to fully capitalize on available opportunities
• Highly organized with developed time management skills
• Excellent verbal and written communication skills
• Ability to develop presentations to effectively communicate current state, future state and other key stakeholder information
• Experience in computer programs such as EMRs, Word, Excel, PowerPoint
  
  

Benefits

• Medical, Dental, Vision
• STD/LTD
• Voluntary Insurance programs including hospital indemnity and critical illness
• FSA
• 401k (employer contribution after 12 months of continuous employment)
• Paid Time Off (accrues with first paycheck)
• Employee Assistance Program
• Paid Holidays
• Paid Bereavement