Billing Specialist/Temporary

Agendia Inc.•Irvine, CA

13h

About The Position

AIM OF THE POSITION The purpose for this position is for an individual to prepare, process, maintain, and manage all aspects related to Billing including benefit and eligibility verification, Order Entry, QC, primary billing and proper documentation. POSITION WITHIN THE ORGANIZATION 1. Customer Care, Sales, Commercial and external vendors 2. Cooperates with all departments across the organization

Requirements

High School diploma or general education degree
3+ years related experience preferable
Medical Billing Certification or work experience equivalency
CPT and ICD-10 knowledge
Advanced technical knowledge of Microsoft products required (Excel, Word, Outlook)
Must be able to work in a fast-paced environment
Must have strong organizational skills and attention to detail
High degree of accuracy
Manage Multiple tasks independently
General accounting and math skills
Excellent problem resolution
Excellent customer service skills
"Outside the Box" thinker
Other Skills necessary: Analytical thinking , thoroughness, good research skills, and strong verbal/written communication
Ability to read and extract information from a path report

Responsibilities

Primary Billing
QC of order entry in SFDC orders, as well as payor selections
Data entry and transfer daily to the Billing System
Generate charges and electronic claims and print paper claims for various payors requiring paper claim submission
Utilize Sales Force for tasks and logging calls, and follow-up to assigned collectors, prior -authorizations, or Patient Care Specialist.
Manage interface errors and upfront claim rejections
Perform other related duties as required or assigned such as overflow work, including word processing, data entry, and internet research tasks
Interface with insurance company representatives, doctor's offices and hospitals regarding the obtainment of medical records, patient demographic and insurance information, and ICD-10 codes.
Verification of eligibility and medical benefits utilizing appropriate site or vendor and enter benefit detail in Sales Force.
Ensure in verification of coverage criteria depending on payer policy and interact with Customer Care if anything is needed for coverage verification.
Utilizes strong analytical skills, including data compilation and attention to detail needed to prepare charges, identify criteria for testing and the ability to request missing information that could hinder a successful claims submission
Uses the chain of command to escalate problems or situations requiring administrative intervention and notifies the Reimbursement Supervisor or Manager when appropriate.
Reviews pathology reports and extracts data to determine coverage criteria based on payer policy.
Maintain client relationships as it pertains to Benefit and Eligibility duties and contacting patient when requested.
Assists in the development of new procedures and systems to enhance productivity.
Works directly with Reimbursement Supervisor , Manager, and Director to address and resolve any issues that may affect the Reimbursement Department as a whole.
Interacts with the Customer Care team to resolve any tasks and issues that can prevent an order from processing and billing.