Job Description
Position: Back Office Manager (With Optometry Experience)
Location: Remote
Type: Full-time
About the role
We are seeking a detail-oriented Back Office Manager who is well-versed in pre-authorization processes, medical copays, and CPT codes. This position is essential for managing the financial operations of our healthcare facility, ensuring accurate billing practices, and maintaining efficient filing systems to support our revenue cycle management.
Key responsibilities
Leadership and Supervision
- Build out, oversee and manage the Billing and Filing Department.
- Train, mentor, and evaluate billing and filing staff.
- Delegate tasks and set deadlines for the team.
- Conduct performance appraisals and implement corrective actions when needed.
Operational and Back-Office Management
- Develop and implement best practices for all billing, filing, and back-office processes.
- Create, revise, and enforce Standard Operating Procedures (SOPs) related to billing, filing, reporting, and document management.
- Oversee the management of patient records, insurance claims, and financial documents.
- Conduct regular audits and risk assessments to ensure compliance and process efficiency.
- Optimize document management and storage solutions to ensure quick retrieval and security.
- Identify and implement automation opportunities to streamline back-office workflows.
- Collaborate with cross-functional teams to improve interdepartmental coordination.
Core Billing and Filing Functions
- File insurance for medical and vision.
- Handle claim submission both electronically and on paper for Vision and Medical Insurance.
- Process orders for glasses and contacts through respective insurances.
- Final auditing of daily invoices to ensure accurate charges.
- Manage insurance payment postings (vision and medical).
- Oversee insurance check deposits.
- Manage follow-ups and corrections for rejected medical claims.
- Direct insurance appeals across all providers.
- Coordinate benefits between medical and vision insurances to maximize reimbursement.
- Stay abreast of industry regulations and changes in billing and filing for medical and vision.
Revenue Management
- Manage accounts receivable, auditing for accuracy and ensuring optimal A/R levels.
- Develop and execute strategies to increase revenue streams through billing and filing.
- Customer Service and Communication
- Manage patient inquiries about statements.
- Facilitate regular staff training sessions to minimize billing and filing errors.
- Produce training material, including documents, videos, and classes.
- Use effective communication to provide updates, changes, and feedback to team members.
Metrics for Performance
- A/R amounts at 30, 60, 90, 120+ days
- A/R goal is to maintain under $100k total with zero at 120+ days
- Write-off amounts relative to client goal
- Team performance to goals and creating a high performing team.