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About the Role
Warby Parker is seeking an operational expert to manage the insurance billing and reimbursement lifecycle, serving as the functional owner of critical financial and operational workflows including claim submission, accounts receivable, and claims support oversight. This role involves close collaboration with Accounting and Technology teams to address financial and system impacts.
Responsibilities
- Own the insurance revenue cycle, managing billing, claim, and reimbursement workflows for timely payment.
- Manage the reconciliation of carrier reimbursements.
- Support the monthly accounting close cycle, including journal entries, schedule preparation, and variance analyses.
- Partner with the Technology team on fee schedule set-ups and technical implementations.
- Support execution through strategy development, testing, and documentation.
- Oversee day-to-day tactical work, including quick resolution of exceptions related to claims submissions, front-end denials, and carrier adjudication.
- Identify trends in claim exception reasons and recommend process improvements to reduce denial rates.
- Manage the relationship with our claims clearinghouse and other vendors to ensure smooth data transmission.
- Develop and maintain SOPs, protocols, and policies related to claims and payments.
- Serve as the internal coding and claim expert to ensure compliance; identify fraud risks and take action to mitigate them.
- Handle fee schedule maintenance and documentation to ensure accuracy across systems.
- Oversee the testing and maintenance of 837 (claims) automation.
- Create reports and analyses to monitor the performance of insurance AR and support audits.
Requirements
- 5+ years of experience in medical insurance billing and revenue cycle management.
- Resourceful self-starter who is detail-oriented and thrives on managing tactical workflows and deadlines.
- Analytical thinker with strong financial acumen.
- Comfortable managing payment reconciliations, variance analyses, and the monthly accounting close cycle.
- Process-oriented problem solver who can identify trends in claim denials to drive system improvements and develop comprehensive SOPs.
- Expert at navigating complex stakeholder environments, with a proven track record of building consensus and driving cross-functional alignment.
- Well-rounded communicator, collaborator, and presenter who can articulate a compelling vision and share actionable insights.
- Not on the Office of Inspector General’s List of Excluded Individuals/Entities (LEIE).
Experience Level
- 5+ years of experience
About the Company
- Warby Parker is on the lookout for an operational expert to join our team and manage our insurance billing and reimbursement lifecycle.