Billing Lead

CLEAR SIGHT PARTNERS, LLC•Brandon, FL

2h•Onsite

About The Position

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

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.
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
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

Nice To Haves

Medical Billing Coder Certification preferred.

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