Medical Billing and Collections Manager

**FORTA’S MISSION**:
Forta is clearing the path to quality healthcare by delivering the best possible outcomes with the utmost convenience. 1 in 36 children [CDC, 2023] is diagnosed to be on the autism spectrum. Currently, autism support via Applied Behavior Analysis (ABA) is difficult to access and the delivery model must be expanded to provide earlier access to families.

**Key Responsibilities**:
**Billing**:

- Oversee and manage the daily operations of the medical billing department.
- Ensure accurate coding and submission of claims to insurance companies, Medicare, Medicaid, and patients.
- Assign and ensure timely claims processing, identifying and resolving any issues that may delay payment.
- Regularly review and audit billing processes to ensure compliance with industry regulations and standards.

**Collections**:

- Develop and implement effective collection strategies to minimize outstanding receivables.
- Monitor aging reports and follow up on unpaid or denied claims, coordinating with payers and patients as needed.
- Negotiate payment arrangements and manage patient billing inquiries and disputes.
- Handle escalated collection issues and coordinate with external collection agencies when necessary.

**Team Management**:

- Supervise, mentor, and provide hands-on training to billing and collections staff, ensuring they meet performance goals and comply with company policies.
- Conduct regular team meetings to discuss updates, resolve issues, and continuously improve processes.
- Assess staffing needs, participate in hiring, and manage schedules to maintain optimal workflow.
- Actively coach and provide constructive feedback to team members, fostering a collaborative and high-performing work environment.

**Reporting and Analysis**:

- Prepare and analyze detailed reports on billing and collections performance, identifying trends, areas for improvement, and opportunities to optimize revenue.
- Report regularly to upper management on key performance indicators (KPIs), including collection rates, denial rates, and days in accounts receivable.
- Implement corrective actions based on data analysis to improve financial outcomes.
- Be more than comfortable with Excel, data manipulation, and presenting findings in a clear and actionable manner.

**Compliance and Regulations**:

- Ensure that all billing and collection activities comply with federal, state, and local regulations, including HIPAA and other healthcare laws.
- Stay updated on changes in billing codes, payer policies, and regulatory requirements, and ensure that the team is informed and compliant.

**Technology and Process Improvement**:

- Work closely with IT and other departments to optimize the use of billing software and systems.
- Identify and implement process improvements to enhance efficiency and accuracy in billing and collections.
- Manage system updates and ensure staff are trained on new software features or changes.

**Strategic Leadership**:

- Develop and execute the strategic plan for the billing and collections department in alignment with the organization’s overall goals.
- Provide leadership and direction to billing and collections teams, ensuring effective execution of departmental objectives.
- Collaborate with senior management to set financial goals, forecasts, and budgets for the department.

**Compliance and Risk Management**:

- Ensure that all billing and collection activities comply with federal, state, and local regulations, including HIPAA, Medicare, Medicaid, and other payer requirements.
- Maintain up-to-date knowledge of industry regulations and ensure the team is informed and compliant with changes.

**Qualifications**:

- At least 6 years of experience in the Medical Billing and Collections, including a minimum of 3 years in a managerial role or higher-level role. (preferably in a startup or fast-paced environment.)
- Strong hands-on experience with MS Office - Excel, PowerPoint, Google Workspace, data analysis, and reporting.
- Excellent leadership, coaching, delegation, and team-building skills.
- Ability to streamline processes and drive continuous improvement.

We are looking for you A driven, innovative, client-focused individual to join our team as we innovate the care and tools available to neuro-diverse families. If this position sounds like the opportunity you have been searching for, we want to speak with you

We look forward to working with you

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- All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. Forta is a Drug-Free Workplace/ EO employer - M/F/Veteran/Disability._