Genomics Reimbursement Analyst

CooperCompanies•Trumbull, CT

17h

About The Position

The Genomics Reimbursement Analyst is part of the CooperGenomics revenue cycle team and is responsible for resolving outstanding billing inquiries and collecting clinic, patient, and insurance revenue accurately and promptly while providing exceptional customer service. The role maintains patient and client billing records; collects payments for services; submits clean insurance claims; follows up on and resolves outstanding balances; responds to customer service inquiries; and performs additional duties or assignments as directed by management. This position supports collections, customer service, accounts receivable analysis, insurance claim follow-up, account reconciliation, and refund research and documentation. The work involves decision-making and work design that affects more than one department area. The employee must be able to work between 6:00 a.m. and 8:00 p.m. PST, Monday through Sunday, and may be required to work weekends and holidays. The role is performed in an environment where the nature of the duties presents little or no potential for job-related accidental injury.

Requirements

Associate degree or 3–5 years of relevant experience in collections.
Healthcare revenue cycle operations experience.
Knowledge of medical billing conventions, including CPT, ICD-10, explanations of benefits, CMS-1500 forms, and client-style billing.
Thorough understanding of differences between in-network and out-of-network insurance claims.
Complex understanding of insurance payer requirements, guidelines, and appeals processes.
Extensive knowledge of patient out-of-pocket expenses, including co-pays, deductibles, and co-insurance.
Excellent written and verbal communication skills, including the ability to communicate effectively with managers, executives, peers in other departments, patients, IVF clinics, and sales personnel.
Computer competency that includes a solid grasp of MS Word and above-average skill with MS Excel.
Reliability, good organizational skills, and ability to take direction.
Ability to work collaboratively in a team and build relationships with counterparts in other departments.
Ability to maintain confidentiality of data, including HIPAA- and SOX-related data.
Ability to consistently meet deadlines in a fast-paced, changing, high-tech environment.
Ability to work between 6:00 a.m. and 8:00 p.m. PST, Monday through Sunday.
May be required to work weekends and holidays.

Responsibilities

Support processes for past-due collections.
Collect client and patient billing payments.
Communicate with customers by phone and/or email.
Compile accessions (invoices) that have completed the dunning cycle for referral to outside collections.
Follow up with clinics on outstanding client-bill accounts receivable.
Assist patients and clients with billing questions received electronically or by telephone.
Assist the Client Services team with pending patient inquiries.
Follow up on denied and unanswered insurance claims.
Monitor and resolve EP Denial errors daily accurately, efficiently, and compliantly to support clean claim submission and reduce days in accounts receivable.
Research eligibility rejections, including contacting patients to determine current insurance coverage.
Communicate payer-trend findings to the Manager.
Research refund requests from patients and insurers; prepare and document refunds for referral to Accounts Payable.
Perform account reconciliation.
Maintain patient and client billing records, collect payments for services, submit clean insurance claims, and follow up on outstanding balances.
Perform additional duties or assignments as directed by management.