The Breastfeeding Shop

Business Operations

• Manage day-to-day system administration across Salesforce, billing platforms, and website integrations to maintain operational continuity and reporting accuracy
• Optimize Salesforce configuration, workflows, automation, and reporting
• Lead smaller-scale system improvement projects
• Manage integrations and ensure accurate data flow
• Translate business needs into system requirements
• Improve documentation and internal system standards
• Support data quality and reporting accuracy and visibility for leadership
• Coordinate vendors or technical support resources
• Assist with system updates and enhancements
• Develop user documentation and support training initiatives
• Partner with operations leadership on ongoing system improvements
• Monitor system performance and recommend incremental improvements.

Business Systems Manager

Billing Specialist

• Submit DME claims accurately and timely to Medicare, Medicaid, TRICARE, and commercial payers
• Ensure proper use of HCPCS codes , modifiers, units, and diagnosis codes
• Verify documentation requirements including prescriptions, CMNs, medical necessity, and proof of delivery (POD)
• Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs)
• Post payments, adjustments, and denials accurately
• Research, correct, and resubmit denied or rejected claims
• Manage payer follow-up for unpaid or underpaid claims
• Identify trends in denials and provide recommendations for process improvement
• Prepare and submit appeals with supporting documentation
• Monitor accounts receivable (AR) aging and prioritize follow-up
• Communicate with payers, clearinghouses, and internal teams to resolve issues
• Maintain accurate patient and payer records within the billing system
• Ensure compliance with CMS, Medicare, Medicaid, and payer-specific billing guidelines
• Stay up-to-date on changes in payer policies, fee schedules, and regulations
• Maintain HIPAA compliance and patient confidentiality at all times

Business Systems Manager

DME Billing Specialist