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Billing and Insurance Advocate

4 months ago

Norwalk, United States Illume Fertility Full time
Job DescriptionJob Description

Company Overview:

Illume Fertility (formerly RMA of CT) specializes in the treatment of infertility, including assisted reproductive technologies (ART) like intrauterine insemination (IUI), in-vitro fertilization (IVF), and pre-implantation genetic testing (PGT). Illume Fertility is Fairfield County’s largest fertility clinic and egg donation center and is led by eight board-certified reproductive endocrinologists. Illume Fertility is consistently recognized as an LGBTQ Healthcare Equality Leader and its Integrated Fertility & Wellness program offers holistic support via acupuncture, mental health counseling, support groups and nutritional counseling. lllume Fertility has 5 convenient locations in Norwalk, Danbury, Stamford and Trumbull, CT and Harrison, NY.


Position Overview:

**There are three (3) open positions at our Danbury, CT facility, and one (1) open position at our Trumbull, CT facility.

Responsible for coordinating insurance/benefits in relationship to treatment dictated by physician. Works in collaboration with clinical and other administrative staffs to ensure billing to insurance/patient are consistent with RMACT’s professional standards and clinical practices.


Duties and Responsibilities:

  • Insurance verification.
  • Counsel patients regarding insurance benefits so that they are educated on all financial obligation dictated by their insurance.
  • Make certain that patients are knowledgeable of financing, payment plans, and self pay options.
  • Obtain prior authorization/pre-determination for all services requiring it (OI, IUI, IVF, Medications, MRI, CT-scans, Surgical procedures).
  • Maintain a working knowledge of all third-party payer contractual requirements.
  • Answers patient’s questions in a timely accurate and courteous manner.
  • Collect all out of pocket expenses at time of service and balances owed prior to the start of treatment.
  • Perform data entry function to guarantee accuracy into the Athena billing system.
  • Acts as a liaison between patient and insurance carrier.
  • Manages financial files for all patients; making sure all financial forms are up to date and in the patient record (FDS, waivers, referrals, insurance cards, insurance correspondence).
  • Posting of all payments on patient accounts the same business day.
  • Required to enter charges within 48 business hours.
  • Required to make bank deposit as needed.
  • Ability to handle protected health information (PHI) in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) .


  • HIPAA
    The IBA will have access to PHI during the course of their work activities. The IBA will use this information to prepare both patients and medical records for visits with the provider and to keep the flow of work going smoothly in the clinic. Applying the minimum necessary standard of HIPAA, the designated records sets to which this employee will have access include: the full medical record.

  • Non-essential Job Functions:
    • Assure that proper CPT and ICD-9 codes are billed correctly
    • Assist with projects as needed
    • Employee must work one late day each week to cover MD’s late patient days
    • Responsible for scanning patient financial records and insurance correspondence into E-bridge.
    • Employee must familiarize themselves with proper CPT/ICD-9 codes related to patient treatment.

Qualifications

  • High School Diploma or GED equivalent.
  • College degree preferred
  • Previous customer service experience required


Immunization:

Staff member must meet immunizations requirements as stated in the Illume Fertility immunization policy.

  • TB inoculation
  • Flu vaccine
  • Others as they become required

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Employee assistance program
  • Employee discount
  • Flexible spending account
  • Health insurance
  • Health savings account
  • Life insurance
  • Paid time off
  • Referral program
  • Tuition reimbursement
  • Vision insurance


Monday-Friday
40 hours/week