About The Auctus Group LLC Who we are: We’re big on people and culture at the Auctus Group. Our most important role as a company is to provide an amazing working environment for our team. We’ve been work-from-home-warriors since before it was cool. We have an extremely robust benefits package including health, dental, vision, disability, 401K w/ match. Our team gets a month off per year. We support (like encourage and fund) continuing education. We match charitable donations. Our whole goal is: work to live not live to work . Oh and we’re weirdos too…we do remote happy hours and have a book club and goofy stuff like that. Who we’re looking for: Smart, talented, tech-savvy, experienced, go-getter types. You’ll do well if: you like a fast-paced environment, you thrive with change and development, you like giving feedback, you’re a team player, you love learning/sleuthing, you’re big on accountability. About The Role Organize and lead a team to meet performance metrics for productivity & backlogs for charges, claims submissions, payments, refunds, denials, and AR follow up. Maintain fee schedule documents and all other master data tables. Work to integrate and develop systems data to produce reports for operational, managerial, and executive leadership. Includes revenue, projected revenues, cash forecasts, denial metrics, etc. Create and maintain process documentation to outline workflows, roles, and responsibilities required to carry out the goals of the team. Ensure consistent and actionable communication with client contacts, other managers and executive team and offshore billing team. Provide reporting and feedback to the team for correct coding and billing of insurance and patient accounts. Provide feedback to the executive and leadership team regarding trends, process, pain points and areas of improvement. Maintains high ethical standards in compliance with industry and regulatory standards. Research reimbursement guideline/requirement changes, interpret updates, and coordinate subsequent reimbursement policy changes to assure compliance. Other duties as assigned. What You'll Do Problem Solving/Analysis- Ability to assess problem areas and address them effectively. Coordination - Adjusting actions in relation to others' actions. Time Management- Managing one’s own time and the time of others. Communication- Maintain a line of communication with supervisor, dispatcher, and customer. Writing Skills- Written and verbal communication skills are essential to be successful in this position. Customer/Client Focus- Working towards one goal of serving its’ clients needs. Leadership- Ability to take responsibility for the entire team and lead the company appropriately. Technical Skills- Previous experience with computer applications, such as Microsoft Word and Excel. Qualifications 8+ years’ experience in medical billing, with knowledge of current trends in across payer-mix. 5+ years’ experience in management. Outpatient facility coding is strongly preferred. Plastic surgery and dermatology experience is strongly preferred. Bachelor’s or Associate's Degree from an accredited college or university in healthcare administration, business, accounting, or finance Ideal candidate will have experience in a multi-entity organization in the healthcare industry Familiarity with Electronic Health Records (EHR) systems is required Experience with clearinghouse software and oversight of claims submission processes required
About The Auctus Group LLC Who we are: We’re big on people and culture at the Auctus Group. Our most important role as a company is to provide an amazing working environment for our team. We’ve been work-from-home-warriors since before it was cool. We support (like encourage and fund) continuing education. We match charitable donations. Our whole goal is: work to live not live to work . Oh and we’re weirdos too…we do remote happy hours and have a book club and goofy stuff like that. Who we’re looking for: Smart, talented, tech-savvy, experienced, go-getter types. You’ll do well if: you like a fast-paced environment, you thrive with change and development, you like giving feedback, you’re a team player, you love learning/sleuthing, you’re big on accountability. About The Role Manages large amounts of inbound and outbound calls in a timely manner Provides information, resolves problems, and advises customers on statements or concerns they may have regarding the Explanation of Benefit from services they received Follows communication Scripts/Guidelines when needed to handle different clients Works within multiple Billing systems and EHR/EMR system with each call Knowledge of how Health Insurance coverage works Knowledge of the medical claim process Knowledge of the patient statement process Patient payment processing and posting Maintaining documentation of all conversations in multiple systems per conversation Identify billing errors in the claim process when patients call in with a complaint Effectively communicates billing errors and payment issues with clients and team members Performs pre-collection calls Performs miscellaneous job-related duties as assigned Ability to perform complex tasks and to prioritize multiple projects Ability to resolve difficult or stressful customer service issues Ability to multi-task, set priorities and manage time effectively Qualifications Ability to assess problem areas and address them effectively. Managing one’s own time and the time of others. Written and verbal communication skills are essential to be successful in this position. Customer/Client Focus- Working towards one goal of serving clients needs. Previous experience with computer applications, such as Microsoft Office Suite (e.g., Word, Excel, Teams), Adobe, softphone (e.g., RingCentral), web browsers and so on.. Must have excellent organizational and communication skills at all levels, both verbally and in writing. Strong attention to detail. Must be able to address, track and solve problems. Ability to multi-task in a fast paced environment. Ability to work full time hours during regularly scheduled business hours and additional work hours as needed. Ability to work from home with integrity. Skills And Abilities Ability to organize, set priorities, work independently and work well with a diverse group of people is essential. Ability to work effectively as a team member with a strong collaborative management style. Excellent computer skills including Microsoft Office Suite (Outlook, Word, Excel). Ability to operate a computer, learn new types of software and systems, and proficiency in using a 10-key numeric pad required. Required Experience 1-3 years’ experience in operations, with knowledge of organizational effectiveness and operations management Ideal candidate will have experience in a multi-entity organization in the healthcare industry Proven work experience as Operations Coordinator or similar role Outstanding organizational skills Physical Demands Duties The Physical Demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job from home. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job the employee is: Regularly required to sit and talk or hear. Regularly required to use a computer keyboard and mouse. Frequently required to use hands, handle, or feel; reach with hands and arms. Specific vision abilities required by this job include close vision, peripheral vision, depth perception, and ability to adjust focus. Work Environment This job operates in a remote environment. This role routinely uses standard office equipment such as computers, phones, printers, etc.
About The Auctus Group LLC Who we are: We’re big on people and culture at the Auctus Group. Our most important role as a company is to provide an amazing working environment for our team. We’ve been work-from-home-warriors since before it was cool. We support (like encourage and fund) continuing education. We match charitable donations. Our whole goal is: work to live not live to work . Oh and we’re weirdos too…we do remote happy hours and have a book club and goofy stuff like that. Who we’re looking for: Smart, talented, tech-savvy, experienced, go-getter types. You’ll do well if: you like a fast-paced environment, you thrive with change and development, you like giving feedback, you’re a team player, you love learning/sleuthing, you’re big on accountability. About The Role Responsible for interpreting and analyzing coded services provided utilizing standardized medical coding ensuring that all claims billed and collected meet all government or funder mandated procedures for accuracy, integrity, and compliance Reviews and is responsible for being familiar with coding to the degree that they can apply/remove modifiers, spot CPT mismatches based on NCCI edits, recognize fee schedule reimbursement structures related to modifiers and CPTs (e.g., CPT XXXXX reimburses Y and Modifier XX reduces reimbursement by Y), as well as recommend changes. This role is not responsible for coding from an operative note although the skillset therein is favored. Submits paper and electronic billing timely to various payers in accordance with contract requirements including corrections, adjustments, rebilling and proper modifications to claims in accordance with documented billing procedures Reviews rejected claims and researches contract guidelines to ensure corrections, adjustments and proper modifications to claims are worked and resolved timely but generally within 48 hours of receipt – taking an actionable step towards payment every month on every claim for their accounts Works in coordination with The Auctus Group team members, to obtain information relevant to rejected or denied claims, account onboarding, training needs and so on. Maintain current working knowledge of all governmental, funder, contractor mandated regulations or payer requirements as it pertains to claims submissions for services provided Provides continuous updates and information to management regarding ongoing errors, payer related issues, registration issues and other controllable QA related activities affecting reimbursement and payment methodology. More than 2 is a trend. Trends get escalated to Revenue Cycle Managers and Team Leads weekly. Maintain strict HIPAA requirements for client and patient confidentiality at all times Any other duties as assigned Qualifications Strong problem-solving skills with the ability to identify and effectively address issues. Excellent organizational skills with the ability to set priorities, work independently, and collaborate with diverse teams. Proven ability to work effectively as a team player with a collaborative and solution-oriented approach Strategic and proactive mindset, with the ability to anticipate challenges and drive improvements. Proficiency in computer systems, with a strong interest in learning and adapting to new technologies. Knowledge of medical terminology and revenue cycle processes, including insurance verification, billing, collections, cash posting, and coding, is preferred. Strong verbal and written communication skills in English; bilingual proficiency is a plus. Ability to multitask and thrive in a fast-paced environment. Availability to work full-time during standard business hours, with flexibility for additional hours as needed. Ability to maintain professionalism, confidentiality, and productivity while working remotely. Required Education And Experience 1-3+ years of medical billing experience. Ideally in a multi-entity healthcare organization. Candidates must have a reliable computer and high-speed internet to perform job duties efficiently in a remote work environment. Familiarity with Electronic Health Records (EHR). Experience with clearinghouse software. Plastic Surgery and/or Dermatology billing is a plus** Physical Demands The Physical Demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job the employee is: Regularly required to sit and talk or hear. Regularly required to use a computer keyboard and mouse. Frequently required to use hands, handle, or feel; reach with hands and arms. Specific vision abilities required by this job include close vision, peripheral vision, depth perception, and ability to adjust focus. Work Environment This job operates in a remote office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.