Reimbursement Specialist

The Position

*This is a full-time, non-exempt, remote role with a schedule of Tuesday through Saturday, 8:30am-5:00pm PST. 

We are hiring a mid-level Reimbursement specialist to join our team. As a Reimbursement specialist, you will be a critical part of empowering Veracyte to achieve its mission of delivering transformative cancer care to patients by ensuring Veracyte gets reimbursed accurately and in a timely manner.  Your primary role will be to take part in the day-to-day operations of the insurance billing life cycle to facilitate a smooth reimbursement process (i.e., verifying patient insurance coverage and benefits, ensuring timely insurance claim submissions, payment posting, performing A/R Follow-Up, sending appeals). To accomplish this, you will need to work with insurance companies, internal teams, customers and patients with compassion and clarity while also having strong knowledge of healthcare reimbursement systems, insurance regulations, and compliance standards.

Responsibilities include:

• Researching and monitoring specific billing issues, trends and potential risks
• Reviewing and ensuring claims are submitted accurately with all pre-claim requirements.
• Ability to track the status of claims and pull reports to manage work (especially in Excel)
• Review denied/unpaid claims and take appropriate corrective action with minimal guidance
  (i.e., resubmission, appeal etc.)
• When requested, providing administrative support for department(s) including but not limited to performing data entry, updating various record keeping systems, upholding company policies and Client requirements, and participating in projects, duties, and other administrative tasks.

• Navigating payor portals, website or phone systems to check Eligibility, Prior Auth, Claim or Appeal statuses to obtain information needed to move claims forward in the life cycle
• Knowledge of payer guidelines and policies with ability to integrate it into daily decision making
• Assisting patients with navigating the financial journey with compassion and accuracy.
• Verifying insurance/recipient benefits with Medicare, Medicaid and Private Insurer Payers.
• Ensuring accurate and timely completion of billing responsibilities each day
• Reviewing and interpreting explanation of benefits

 

Who You Are

Education

• High school diploma or GED
• Associate's or bachelor's degree in healthcare administration, business, or related field preferred
  
  

Experience/Qualifications

• Use of personal computer, computer applications, and general office equipment.
• Experience with Microsoft Office (especially Word and Excel)
• 2+ years of experience in medical billing, insurance claims, or revenue cycle operations
• Experience with payer portals and claim tracking systems
• Familiarity with HIPAA compliance and healthcare privacy regulations
• Experience working with in CRMs (i.e., Salesforce) and Billing Software (i.e., Epic, XiFin, Quadax)
• Strong, consistent work ethic with attention to detail and ability to focus on the big picture.
• Ability to use analytical, interpersonal, communication, organizational, numerical, and time management skills.
• Good organization skills with ability to meet deadlines and manage several projects at a time.
• Enthusiasm and an entrepreneurial spirit
• Familiarity with ICD and HCPCS/CPT coding preferred.
• Familiarity with CMS 1500 claim form preferred.
• Familiarity with Claim Adjustment Reason Codes (NUCC) preferred

 

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