Genomics Reimbursement Analyst

Genomics Reimbursement Analyst

Trumbull, CT, United States

(On-site)

Job Description

The Genomics Reimbursement Analyst is a member of the CooperGenomics revenue cycle team, responsible for resolution of outstanding billing inquiries and collection of clinic, patient, and insurance revenue in an accurate and timely manner while providing exceptional customer service. This individual is responsible for maintenance of patient and client billing records, collection of payments for services, submission of “clean” insurance claims, follow-up and resolution of all outstanding balances, responding to customer service inquiries, and performing additional duties or assignments as directed by management.

Responsibilities

• Support the processes for past-due collections.

• Collections for Client and Patient Billing

• Communication via phone and/or email

• Compilation of accessions (invoices), which have completed the dunning cycle for referral to outside collections

• Follow-up with clinics on outstanding “Client-Bill” AR

• Customer Service

• Assist patients and clients with resolution of billing questions received both electronically via telephone

• Assist Client Services team with pending patient inquiries

• Accounts Receivables Analysis

• Follow-up on denials and no response insurance claims

• Daily monitoring and resolution of “EP Denial” errors in an accurate, efficient, compliant manner to ensure “clean claim” submission and reduce days in AR

• Research eligibility rejections including contacting patients to determine current insurance coverage

• Communicate finding of payer trends to Manager

• Research refund requests from patients and insurance; prepare and document refunds for referral to AP

• Account reconciliation is required

• Knowledge of medical billing conventions including (but not limited to) CPT, ICD-10, explanation of benefits, CMS-1500 form and client-style billing.

• Thorough comprehension of the differences between in-network insurance claims and out-of-network insurance claims

• Complex understanding of insurance payor requirements, guidelines, and appeals processes

• Extensive knowledge of patient out-of-pocket expenses including co-pays, deductibles and co-insurances.

• Excellent written and verbal communications skills including the ability to effectively communicate with managers, executives, peers in other departments, patients, IVF clinics and sales personnel

• Computer competencies to include solid grasp of MS Word and above-average skill with MS Excel.

• Reliability, good organization skills, and able to take direction.

• Ability to work collaboratively in a team and build relationships with counterparts in other departments.

• Must be able to maintain confidentiality of data including HIPAA, SOX and other similar regulations.

• Consistently meet deadlines in a fast-paced, changing, and hig-tech environment.

• This job involves decision making and work design that affects more than one department area.

Work Environment:

• Occupational Risks: Nature of duties performed presents little or no potential for job-related accidental injury.

• Must be able to work between 6:00 am and 8:00 pm PST, Monday – Sunday

• May be required to work weekends and holidays

Qualifications

Experience/Education:

• Associate degree or 3-5 years relevant experience in collections

• Healthcare revenue cycle operations experience

• We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. If you are interested in applying and require special assistance or accommodations due to a disability, please contact us at [email protected].

• As an employee of CooperVision you'll receive a competitive total compensation plan. Your recruitment team will be able to share more information about any variable pay opportunity and benefit package that accompanies this role. The good faith estimate of the salary range for this role is $30-$35 per hour. The actual amount offered is determined by a number of factors including but not limited to location, skills and experience.