Supervisor Order Entry Authorization

BREG • Carlsbad, CA

77d • $58,800 - $78,600

About The Position

At Breg, we are dedicated to advancing orthopedic solutions that enhance the lives of patients and support healthcare professionals. As a leader in the orthopedic industry, we provide innovative products, consulting, technology, and services that help people move forward with confidence. We are currently seeking a Supervisor, Order Entry and Authorizations to join our team in Carlsbad, CA. If you thrive in a dynamic environment where innovation and impact go hand in hand, this is the opportunity for you.

Requirements

• Associated degree in an applicable field of study or 2-3 years of relevant experience, or equivalent combination.
• Certified Medical Coder required (AHIMA or AAPC credentials accepted).
• Experience managing or supervising people; Experience with offshore vendor engagement is a plus.
• Proficient in reimbursement principles, medical terminology, payer groups and networks, including Medicare, worker's compensation, and private insurance.
• Computer proficient to include web browser/internet search, MS Outlook, Word, Excel and PowerPoint capabilities.

Nice To Haves

• A passion for innovation and a commitment to Breg's mission to Keep Moving Forward.

Responsibilities

• Supervise and oversee all aspects to Breg's vendor engagements responsible for order entry and coding.
• Manage the process of accurately entering order information into billing systems, verifying patient eligibility, obtaining prior authorizations, ensuring that claims are submitted correctly to payors, leading to timely and accurate reimbursement driving the achievement of KPI's.
• Analyze reports to prioritize claim finalization and determine appropriate actions to be taken to achieve key results.
• Act as an individual contributor as needed and provide coverage for coding (on/offshore) and will work alongside the Order Entry team and authorization teams, assisting with claim volume processing when necessary.
• Serve as the subject matter expert and escalation resource for order entry and coding.
• Partner with Revenue Cycle Management leaders, Field Operations, HIMS, Quality, Payor Contracts, and other leaders to develop and implement strategies to reduce pending claims and expedite accurate claim submission.
• Collaborate with Manager and other leaders to recommend process improvements and contribute to the development of new procedures and work instructions.
• Monitor audit reports for quality and process adherence, communicate identified areas requiring additional training or documented business processes/work instructions.
• Leadership responsibilities include selection, development, performance management and continuous recalibration of staff.
• Assess staff and provide timely and consistent feedback regarding technical proficiency and effectiveness.
• Partner with Breg Training Personnel on new and/or revised processes, policies, procedures and training documents specific to order entry and authorization.
• Perform duties in compliance with applicable HIPPA, FDA, CMS, ACHC, and other appropriate state and federal regulations.
• Promote Breg's culture within the organization using established tools such as storytelling, providing focused feedback, and recognition.

Benefits

• Comprehensive Benefits: Medical, dental, vision, disability, and life insurance, effective the first of the month after hire.
• Work-Life Balance: Paid Time Off (PTO) and company-paid holidays.
• Growth & Development: Opportunities for professional advancement within a company that values your contributions.
• Commitment to Diversity & Inclusion: Breg is proud to be an Equal Employment Opportunity employer, fostering a diverse and inclusive workplace.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Merchant Wholesalers, Durable Goods
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees