Billing Associate

Personalis•Fremont, CA

4d•Hybrid

About The Position

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.

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.