[Hiring] Reimbursement Account Specialist I @Adaptive Biotechnologies

Role Description

The Reimbursement Account Specialist I supports patients, providers, and internal teams throughout the reimbursement lifecycle. This role works closely with the Sr Reimbursement Account Specialists to manage inbound inquiries, coordinate documentation needs with provider offices, update billing and diagnostic information, and ensure accurate case and clinical order handling across multiple systems. The ideal candidate is detail oriented, comfortable navigating complex workflows, and committed to delivering a positive experience for all stakeholders.

Key Responsibilities and Essential Functions

• Inbound Call Management
  • Manage inbound calls from patients, provider accounts, and payers regarding reimbursement issues, billing status, prior authorizations, and Adaptive Assist enrollment.
  • Identify the nature of each inquiry and triage calls to the appropriate teams when needed.
  • Provide clear, accurate, and empathetic support to all callers.
• Provider Outreach & Documentation Follow-up
  • Contact provider offices to obtain outstanding documentation required to move reimbursement requests forward.
  • Communicate required materials, confirm provider understanding, and document commitments to submit missing information.
  • Maintain accurate, timely documentation to support reimbursement workflows and audit readiness.
• Patient Financial Assistance Support
  • Assess all self-pay patients and patients with outstanding balances for eligibility into Adaptive.
  • Assist Patient Support Program’s financial assistance and enroll qualifying patients.
  • Document assistance qualifications into the internal and billing vendor patient records.
  • Audit the PFAP on a regular basis to compliance with all current guidelines.
• Order Review & Eligibility Assessment
  • Collaborate with internal partners to run needed orders through external vendor platforms to check for insurance eligibility and/or financial assistance qualification.
  • Review patient bills for appropriateness and release when necessary.
  • Collect pre-payment from appropriate self-pay patients.
  • Work with customers and embassies to collect payment for international patients.
  • Contact patients for Advanced Beneficiary Notices when needed.
• Pre Diagnosis Workflow Management
  • Evaluate held orders for proper ICD codes, needed documentation and other requirements.
  • Update orders and resolve holds when appropriate.
• All other duties as assigned

Qualifications

• Bachelors degree in related field or equivalent experience
• Familiarity with basic laboratory and customer service-related systems such as LIMS and SFDC, or similar systems
• Proven track record of improving processes and solving problems.
• Demonstrated ability to work effectively with physician office clients and with patients on billing-related matters
• Excellent written communication skills are required, including technical computer proficiency (Word, Excel, etc.)
• Strong ability to work independently, think critically and problem solve
• Ability to work effectively across multiple functions within the organization and customer’s offices
• Strong interpersonal skills and experience navigating organizational dynamics
• Use of empathetic listening skills in communication with customers
• Flexible, team-player with ability to develop best practices for procedures on new assignments.
• Strong attention to detail and meticulous data entry skills
• Ability to manage multiple tasks to completion in a dynamic office setting.

Requirements

• 1-2 years in customer service, medical billing, and revenue cycle operations
• Direct knowledge of ICD-10 codes, CPT codes, and general billing practices in the laboratory services space
• Knowledge and familiarity with patient assistance programs

Benefits

• Hourly Rate: $26.01 - $35.14
• Equity grant
• Bonus eligible

Company Description

Adaptive Biotechnologies is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.