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Firefly Health Operations Associate - Billing & Insurance Coordination in Watertown, Massachusetts

Firefly Health is building a revolutionary new type of comprehensive health "care and coverage,” powered by a relationship-driven care team, a trusted virtual and in-person clinical network, and our proprietary technology platform.

Founded by experienced clinicians and technology leaders, Firefly Health is on a mission to deliver half-priced health care that's twice as good, clinically and emotionally. We are flipping the script on what it means to be a health plan and actually providing a true health benefit to members.

We are intensely focused on optimizing the physical + mental + financial wellbeing of those who want (and deserve) something better than the status quo. If you are ready to roll up your sleeves and take on our audacious mission, then we would love to hear from you.

Your Role

The Billing & Insurance Coordination Associate role serves as a communication link between our facility and the members financial responsibilities. Responsibilities include but are not limited to management of communication in a constantly changing, fast paced environment focused on professional and expedient customer service. This position requires the ability to prioritize and work on a daily basis with minimal supervision and have open communication with other departments within Firefly to reach a shared goal.

What You'll Do (and Much More!)

  • Insurance Referrals & Prior Authorizations: Assist patients when insurance certifications and/or authorizations are needed providing updates throughout the referral process by working the “Insurance Approval Worklist”.

  • Eligibility and Visit Prep: On a daily cadence run established and new member eligibility to determine coverage for next day visits.Contact members with insurance issues, maintain active list of insurances accepted at Firefly Health.Keep Provider Directories with Commercial Insurances up to date.

  • Member Attribution: Confirm members have signed a “Provider of Choice” form to communicate back to the payer for attribution purposes. Ensure all members with commercial HMO and POS benefit plans have selected a Firefly Health Provider.

  • Billing Tasks: responsibilities include managing medical billing for fee for service members, updating patient information, generating invoices, processing payments, monitoring billing AR, Charges, and Payment clarifications, monitoring denials. Maintaining communication with our billing vendor, Practice Suite.

  • Member Discharges: Follow protocol for Members who self discharge or are discharged by the practice.

  • Additional project work to support growth and scalability

What You'll Bring Us:

  • 2+ years in the healthcare industry with knowledge and experience working medical referrals for patients

  • +1 year Medical Billing and Coding experience preferred

  • Excellent communication skills - you will be working directly with patients on a daily basis

  • Must be detail-oriented and have fantastic organization skills

  • Firefly Health is rapidly growing and you should be comfortable with change and rapid growth

  • Being a self-starter, a team player, with an incredible drive to see Firefly succeed, and flexibility to help in whatever ways are needed

Our office is located in Watertown, Massachusetts, but we’ve developed a robust remote working structure to give us more flexibility geographically while hiring for many positions.

Firefly is an equal opportunity employer. We value diverse backgrounds and perspectives. We're committed to building and sustaining an inclusive workplace culture where individuals are treated with dignity and respect. All employment is decided on the basis of qualifications, merit, and business need.