Supervisor Order Entry Authorization

Join Our Team and Keep Moving Forward with Breg!

At Breg, we are dedicated to advancing orthopedic solutions that enhance the lives of patients and support healthcare professionals. As a leader in the orthopedic industry, we provide innovative products, consulting, technology, and services that help people move forward with confidence.

We are currently seeking a Supervisor, Order Entry and Authorizations to join our team in Carlsbad, CA. If you thrive in a dynamic environment where innovation and impact go hand in hand, this is the opportunity for you.

You are a forward-thinking professional who values collaboration, innovation, and making a meaningful difference. You bring expertise in the ability to communicate effectively both written and verbally and are eager to contribute to a team that is committed to delivering exceptional patient outcomes.

As a Supervisor, Order Entry and Authorizations, you will:

• Supervise and oversee all aspects to Breg's vendor engagements responsible for order entry and coding. Managing the process of accurately entering order information into billing systems, verifying patient eligibility, obtaining prior authorizations, ensuring that claims are submitted correctly to payors, leading to timely and accurate reimbursement driving the achievement of KPI's.
• Analyze reports to prioritize claim finalization and determine appropriate actions to be taken to achieve key results.
• Act as an individual contributor as needed and provide coverage for coding (on/offshore) and will work alongside the Order Entry team and authorization teams, assisting with claim volume processing when necessary.
• Serve as the subject matter expert and escalation resource for order entry and coding.
• Partner with Revenue Cycle Management leaders, Field Operations, HIMS, Quality, Payor Contracts, and other leaders to develop and implement strategies to reduce pending claims (first-time finalization) and expedite accurate claim submission to secure reimbursement without additional intervention (first-time realization).
• Collaborate with Manager and other leaders to recommend process improvements and contribute to the development of new procedures and work instructions.
• Collaborate with the Manager to put together and communicate (orally and in written form) strategies, plans, performance outcomes, and business conditions to ensure understanding of the current state of claims processing and opportunities for process improvement.
• Monitor audit reports for quality and process adherence, communicate identified areas requiring additional training or documented business processes/work instructions.
• Leadership responsibilities include selection, development, performance management and continuous recalibration of staff; ensures appropriate staffing levels and resource allocation; performs administrative tasks associated with timekeeping, pay, performance, policy administration and other matters related to employment.
• Assess staff and provides timely and consistent feedback regarding technical proficiency and effectiveness. Provides constructive feedback, guidance, and reinforcement to employees regarding job performance. Works with staff to identify work goals and create individual development plans. Evaluates training programs to ensure content meets staff needs.
• Partner with Breg Training Personnel on new and/or revised processes, policies, procedures and training documents specific to order entry and authorization.
• Evaluates training programs. Supports vendor's training of new and existing teammates to increase order entry and authorization efficiency and overall company profitability.
• Performs duties in compliance with applicable HIPPA, FDA, CMS, ACHC, and other appropriate state and federal regulations.
• Responsible for behaving in a professional manner both internally and externally in relationships that positively impact the company's reputation and comply with the company's policies and practices. Responsible for bring accountable and committed to demonstrating Breg's cultural beliefs and achieving the key results of the company.
• Responsible for promoting Breg's culture within the organization using established tools such as storytelling, providing focused feedback, and recognition. The performance of the position is aligned with the culture of commitment and accountability, following the steps of:
  See it, Own it, Solve it, Do it.

• Associated degree in an applicable field of study or 2-3 years of relevant experience, or equivalent combination. Relevant experience includes healthcare management with DMEPOS/other company that performs Medicare Part B and other health insurance reimbursement functions.
• Certified Medical Coder required ( AHIMA or AAPC credentials accepted)
• Experience managing or supervising people;
  Experience with offshore vendor engagement is a plus.
• Proficient in reimbursement principles, medical terminology, payer groups and networks, including Medicare, worker's compensation, and…