Billing Associate

Personalis, Inc•Fremont, CA

5h•$26 - $32•Hybrid

About The Position

At Personalis, we are transforming the active management of cancer through breakthrough personalized testing. We aim to drive a new paradigm for cancer management, guiding care from biopsy through the life of the patient. Our highly sensitive assays combine tumor-and-normal profiling with proprietary algorithms to deliver advanced insights even as cancer evolves over time. Our products are designed to detect minimal residual disease (MRD) and recurrence at the earliest timepoints, enable selection of targeted therapies based on ultra-comprehensive genomic profiling, and enhance biomarker strategy for drug development. The Billing Associate holds a pivotal and critical position in supporting Personalis' overarching business objectives. This dynamic role is fundamentally responsible for establishing the foundation to maximize reimbursement for the company's proprietary Next Personal DX test. The core function of this position is to optimize the revenue cycle by meticulously managing the order intake and claim submission processes. A primary responsibility of the Billing Associate is to ensure the absolute accuracy and completeness of the order intake process, which is the initial stage of the revenue cycle. Following this, the Associate is tasked with the precise preparation and submission of "clean claims"—claims free of errors, documentation deficiencies, or missing information—thereby accelerating payment and reducing denials. Furthermore, this role is essential in reinforcing Personalis' deep-seated commitment to patient access to high-quality healthcare. The Billing Associate serves as the primary administrator of the NeXT Access financial assistance program. This involves communicating program details to eligible patients, processing applications, and managing the financial assistance workflow to mitigate the financial burden on patients, ultimately ensuring that more individuals can benefit from the Next Personal DX test regardless of their financial circumstances. You are eager to launch a career in medical billing and the broader revenue cycle management (RCM) process, leveraging your foundational understanding of health insurance benefits. You are focused on mastering RCM best practices, including client and third-party billing, payer structures, claims processing, and specific reimbursement requirements. Your defining trait is a strong attention to detail, which is essential for ensuring the high level of accuracy needed for successful billing outcomes. Furthermore, you possess strong analytical skills and enjoy investigating and troubleshooting issues and discrepancies. This passion for problem-solving is vital for continuous process improvement and maximizing reimbursement. You are known for providing excellent customer service to both internal and external stakeholders, communicating effectively through both written and verbal channels. You thrive in a team environment, actively contributing by learning from others, raising potential system or customer issues during team meetings, and proposing ideas for continual business optimization.

Requirements

0-2 years of experience in medical billing or a related field
High school diploma or equivalent GED.
Exceptional phone etiquette for communication with patients, physicians, and insurance representatives.
Proficient computer skills.
Ability to analyze problems and strategize for better solutions.
Proven ability to multitask, prioritize, and manage time efficiently.
Self-motivated and self-directed, with the ability to work independently.

Nice To Haves

Associate Degree in Business, Marketing, Accounting, Healthcare Administration, or a related field. Including healthcare certifications.
Experience of familiarity with medical insurance benefits and regulations.
Experience with Google Suite.
Working knowledge of billing software (XIFIN)

Responsibilities

Support the claims & order entry processes
Support the order entry process by ensuring all billing data is available for order entry
Determine the coverage status of test orders by reviewing clinical criteria
Obtain medical records and other missing information
Assign the proper test codes based on payer and clinical criteria.
Transfer insurance claims and billing data to billing software (e.g., XIFIN).
Resolve claim and frontend billing errors and manage assigned correspondence queues.
Verify patient benefits and insurance eligibility
Engage with payers to request prior authorization for tests
Administering & supporting patient financial assistance for the NeXT Access program
Arrange payment plans and timelines for payments
Collaborate with the Client Experience team, our commercial partners, and the downstream Billing Operations team
Support activities related to integrating the billing system with LIMs and other IT systems.