FTC Kids Billing Lead Little Falls, NJ · Full time

We are looking for a billing lead who is an expert in Raintree RCM, expertly understands the RCM medical billing process, and has worked within a pediatric clinic.

Description

Our Perfect Candidate:

Faith Therapy Consulting, LLC (FTC) is not just looking to hire a Billing Lead that is looking for a job, FTC is looking for someone that is looking to fulfill their calling and passion. 


FTC is looking for a Billing Lead who has the following capabilities:


  1.  Relationship Building and Networking:  The Ability to establish and maintain positive relationships with vendors, stakeholders, and referral sources.  Skilled in networking, collaborating, and negotiating to achieve mutually beneficial outcomes.
  2.  Project and People Management:  Strong organizational and project management skills to handle multiple responsibilities simultaneously.  Proficient in setting priorities, meeting deadlines, and managing resources effectively. Able to manage 1 direct report in a fair and consistent manner.
  3. Insurance Knowledge: A strong understanding of insurance policies, coverage, and reimbursement processes is essential. This includes knowledge of medical billing codes, claim submission requirements, and the ability to navigate insurance company guidelines.
  4. Claims Processing: Proficiency in handling the end-to-end claims processing cycle, including verifying patient insurance coverage, submitting claims accurately and timely, and following up on outstanding claims. Familiarity with electronic claims submission systems is beneficial.
  5. Documentation Management: The ability to review and interpret medical documentation, ensuring that all necessary information is included for claim submission. Attention to detail is crucial to minimize errors and maximize reimbursement.
  6. Regulatory Compliance: Knowledge of relevant healthcare regulations and compliance requirements, such as HIPAA and insurance billing regulations. Adhering to these regulations ensures patient privacy, data security, and ethical billing practices.

Job Description:

The FTC Kids Billing Lead will be responsible for directly supervising the Authorization and Claims Management Specialist, facilitating Patient Authorizations, Raintree/External or Internal Billing service providers management, and All Billing Quality Control oversight and direct management as needed.


Responsibilities:


  • Review and analyze monthly billing statements from Raintree/External or Internal Billing service providers, for accuracy and completeness before billing parents


  • Ensure that all charges, discounts, and adjustments are accurately reflected in the billing statements according to the agreed-upon terms and pricing.


  • Collaborate with the Finance Manager to reconcile any discrepancies or billing errors identified during the review process.


  •  Maintain a strong working relationship with Raintree/External or Internal Billing service providers, serving as the primary point of contact for any billing-related inquiries or issues.


  • Communicate regularly (weekly) with Raintree/External or Internal Billing service providers to stay updated on changes to their billing processes, policies, and systems.


  • Provide feedback and suggestions to Raintree/External or Internal Billing service providers to improve billing efficiency, accuracy, and customer service.


  • Monitor the performance of Raintree/External or Internal Billing service providers in meeting service level agreements and escalate any concerns or issues to the Business Operations Director.


  • Prepare weekly reports and present findings to the Business Operations Director highlighting key metrics, trends, and recommendations for optimizing the vendor relationship.


  • Monitors and maintains all Quality Control processes for all billing categories: max billing strategies, claims re-submissions, CPT code accuracy review, monthly review of all client accounts, all client billing questions and proactive client check-ins and followup.


  • Directly Supervises the Authorizations and Claims Management Specialist, ensuring all tasks are completed in a timely and accurate manner. 


  • Innovative thinking: Ability to develop and implement new processes to enhance clinic operations. This includes investigating and establishing new codes or specialties for the clinic, as applicable.


  • Liaises with the Client Services Specialist and Therapists directly for scheduling or coding issues as they arise. 


Qualifications:

  • A minimum of 5 years of work experience or an Associate’s or Bachelor’s degree in Business Administration, Healthcare Management, or a related field.
  • Expertise in Raintree RCM.
  • Experience working in a pediatric clinical setting and understanding billing intricacies.
  • Collaborative, proactive, and thorough.
  • Strong focus on operational excellence, demonstrated through continuous process improvement and the implementation of best practices to enhance efficiency and patient care quality.
  • Experience managing a direct report.
  • Availability to work in the clinic Monday-Friday, either 9am-5pm or 10am-6pm.



Benefits:

Full-Time Salary:

  • Competitive Pay with Excellent Benefits
  • Retirement Plan with Employer Match, after qualification period
  • Paid Time Off, Sick Leave, and Paid Holidays
  • Medical/Dental/Vision
  • Professional Education Reimbursement
  • Employee Wellness Reimbursement


Conditions of Employment:

  • You must be eligible to work in the United States
  • Must be proficient in written and spoken English
  • Selected applicant will be subject to background check and random drug testing
  • Must have reliable transportation


Salary

$75,000 - $85,000 per year