Tech Stack

Description

You will focus on increasing insurance collections by managing payor follow-up and appeals of denied claims, analyzing and resolving reimbursement issues, and collaborating with the Market Access team to ensure optimal payment for clinical products.

Requirements

• 5-7+ years billing, coding, and reimbursement experience in CLIA laboratory services sector
• Strong knowledge of Medicare, Medicaid, and private insurance reimbursement processes
• Proficient knowledge of CMS guidelines
• Excellent interpersonal and communication skills
• Ability to work independently and meet deadlines
• Strong problem-solving skills
• Knowledge of medical billing and coding practices
• Proficiency in Microsoft Office and healthcare billing software
• Knowledge of coding modifiers

Responsibilities

• Communicate effectively with payors and internal stakeholders to resolve reimbursement issues
• Support revenue and ASP growth in collaboration with Market Access team and external billing vendor
• Stay current with payor policy changes and regulations
• Provide support and guidance on reimbursement and compliance issues
• Review claims and supporting clinical documents for billing and coding accuracy
• Support reduction in denials percentage, claims underpayments and time to adjudication
• Work with data analytics and revenue operations team to refine analytical tools
• Generate and analyze reports to identify trends and revenue opportunities
• Monitor and maintain payor contract information in billing systems