[Hiring] Revenue Cycle Associate - Collections @BillionToOne

Role Description

We are looking for a Revenue Cycle/Medical Collections Associate to be responsible for focusing on collections and appeals from various Federal, State, & Third Party (HMO, PPO, IPA, TPA Indemnity) payers. This is a remote position and will report to the Manager of Reimbursement Operations. The ideal candidate must be able to:

• Optimize payment reimbursements by reviewing accounts for billing accuracy and health plan coverage.
• Be persuasive and persistent when following up on claims status.
• Process an appeal, resubmit/rebill, or forward claims for adjudication as necessary.

Responsibilities:

• Verify claim was submitted to correct insurance.
• Review/update patient demographics and information for accuracy.
• Process and validate payor requests and claims via correspondence, remittance advice and EOBs (i.e., identify payment discrepancies, inappropriate requests).
• Investigate all denied services to determine reason and appeal, if appropriate. Identify and report root causes associated with denials to reduce/resolve issues.
• Process assigned appeals including submission, tracking, reporting and evaluation of appeal outcomes (i.e., next steps, improved outcomes).
• Maximize utilization of Billing system, tools and resources to support cash collection activities.
• Review various reports including aging outstanding and denial reports.
• Comply with Federal and State legislation on all billing related matters.
• Comply with all Safety, Emergency, Hazard, OSHA, HIPAA, Quality Assurance and Administrative Plans, Policies, Guidelines, Protocol, and Standards.
• Support and maintain department cash and DSO goals.

Qualifications

• Minimum of 4+ years specializing in Medical Collections at a diagnostics company, laboratory or other healthcare provider, doing collections from commercial payers.
• Hands-on experience handling the entire appeals process.
• Must possess detailed knowledge of all medical benefit levels and have a thorough understanding of Federal, State, & PPO, HMO, and Indemnity Plans structures.
• Working knowledge of appropriate coding systems; CPT, ICD-10 and HCPCS, coverage; LCD/NCD and reimbursement associated with such codes.
• High School Diploma or a Bachelor’s degree from a four-year college or university.
• Strong problem solving skills with ability to streamline and improve processes, use good judgment, attention to detail and follow-through are a must.
• Excellent customer service skills; excellent verbal and written communication skills.
• Excellent troubleshooting and time management skills, attention to detail, utilizes time in constructive manner.
• Ability to easily adapt to increased business demands.
• Ability to effectively work with and resolve complex accounts & billing issues.
• Self-starter, ability to work independently and be self-motivated to overachieve goals.
• Ability to effectively prioritize and multi-task.
• Ability to work in fast paced environment, perform under pressure, meet tight timelines.
• Establish and maintain cohesive and good working relationships.

Benefits

• Working alongside brilliant, kind, passionate and dedicated colleagues, in an empowering environment, toward a global vision, striving for a future in which transformative molecular diagnostics can help millions of patients.
• Open, transparent culture that includes weekly Town Hall meetings.
• The ability to indirectly or directly change the lives of hundreds of thousands patients.
• Multiple medical benefit options; employee premiums paid 100% of select plans, dependents covered up to 80%.
• Extremely generous Family Bonding Leave for new parents (16 weeks, paid at 100%).
• Supplemental fertility benefits coverage.
• Retirement savings program including a 4% Company match.
• Increase paid time off with increased tenure.
• Latest and greatest hardware (laptop, lab equipment, facilities).
• For this position, we offer a total compensation package of $65,141 per year, including a base pay rate of $28.47 per hour.