Description
Integrative Medicine Billing & Revenue Cycle Management
Lace’s Vision
Lace Health was founded on the firmly held belief that integrative and functional medicine should be accessible to everyone. The truth is, the potential of integrative and functional medicine has not been actualized because our healthcare system is broken. Practitioners struggle to find the right combination of clinical, business, and financial models that allow them to build successful practices at an accessible price point for the patient. We exist to bridge this gap and make building a successful practice a delight. We're doing that by building a business-in-a-box and platform that makes it easy for practitioners to start and grow their integrative practice. This is a $5 billion opportunity — think about where the mental health market was 10 years ago.
The Role
Ideal candidate will be a goal-oriented, self-motivated, and a proven highly accurate biller in a remote atmosphere. Ideal candidate will fit our commitment to our clients by being the best in the business consistently obtaining every possible dollar for our clients while maintaining the highest level of integrity and compliance. Candidate will demonstrate excellent verbal and written communication skills.
Eligibility & Charge Entry
- Verify patient eligibility and benefits ahead of appointments per practitioner contract; proactively flag coverage issues before the visit so patients and practitioners are never surprised.
- Posting charges or verification of charges from client EMR. This will vary per client contract and candidate should expect to have different methods based on the client needs
- Experience or openness to learn Integrative Medicine practices and the nuance of billing. Staying up-to-date with compliance and regulations.
Claims & Payment Posting
- Prepare, review, and transmit claims using billing software.
- Post all payments.
- Post or validate ERA adjustments per contracts with Medicare, Medicaid, and third-party commercial carriers.
- Check every insurance payment for accuracy and contract compliance; call carriers on any discrepancy and pursue it to resolution.
Hybrid Cash-Pay & Superbill Workflows
- Support practitioners who operate hybrid cash-pay and in-network models: generating accurate superbills for patients seeking out-of-network reimbursement, and clearly communicating what is and isn't billable.
- Help patients understand their financial responsibility, including the difference between covered services and self-pay items common in integrative care.
A/R Follow-Up, Denials & Appeals
- Follow up on unpaid claims within industry-standard billing cycle timeframes; minimize days outstanding.
- Identify and bill secondary and tertiary insurances.
- Research and appeal all denied claims including those denied for medical necessity on integrative services, which often require detailed clinical justification.
Patient & Practitioner Support
- Review accounts for insurance or patient follow-up; set up patient payment plans or work collections accounts where appropriate.
- Answer patient and insurance inquiries with clarity, empathy, and accuracy.
- Update billing software with patient and insurance information as needed.
Who are you?
- 5+ years of experience working in the billing and accounts receivable follow up environment. CPB, CPC or similar credentials are a plus.
- Comfort with at least one major billing platform (e.g. Elation, Athena, Cerbo, Healthie, Practice Better, Simple Practice, etc.)
- Quick learner to learn a new billing system and learn from our integrative billing specialist.
- Solid Excel and Word skills; able to balance a financial day against deposit records.
- Excellent verbal and written communication — you can explain a denial to a stressed patient and write a clean appeal letter to a carrier on the same day.
- Reliable internet and a workspace that meets HIPAA safeguard requirements.
What We Offer
- Competitive hourly salary.
- Part-time opportunity with room to grow to a full time employee.
- Training and mentorship in integrative medicine billing.
- The chance to help shape how a growing company bills from the ground up.
How to Apply
Send your resume and a brief note about why integrative medicine billing interests you to Lili Welch at [email protected].
