Genomics Reimbursement Analyst

CooperCompanies•Trumbull, CT

1d•$30 - $35

About The Position

The Genomics Reimbursement Analyst is part of the CooperGenomics revenue cycle team. The role resolves outstanding billing inquiries and collects clinic, patient, and insurance revenue accurately and promptly while providing exceptional customer service. Responsibilities include maintaining patient and client billing records, collecting payments for services, submitting clean insurance claims, following up on and resolving outstanding balances, responding to customer service inquiries, and completing additional duties or assignments as directed by management. The role supports past-due collections and client and patient billing, communicates by phone and email, compiles invoices that have completed the dunning cycle for referral to outside collections, and follows up with clinics on outstanding client-bill accounts receivable. It assists patients and clients with billing questions and supports the Client Services team with pending patient inquiries. The analyst also follows up on denied and unanswered insurance claims, monitors and resolves EP Denial errors, researches eligibility rejections, reports payer trends to the Manager, researches refund requests and prepares documentation for referral to Accounts Payable, and performs account reconciliations. The position requires knowledge of medical billing conventions, insurance claims and payer processes, patient out-of-pocket expenses, and confidentiality requirements such as HIPAA and SOX. It involves decision-making and work design that affects more than one department. The work environment has little or no potential for job-related accidental injury. 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.

Requirements

Associate degree or 3–5 years of relevant collections experience.
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 copays, deductibles, and coinsurance.
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.
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 and build relationships with counterparts in other departments.
Ability to maintain confidentiality of data, including HIPAA, SOX, and similar regulations.
Ability to consistently meet deadlines in a fast-paced, changing, high-tech environment.

Responsibilities

Support processes for past-due collections.
Collect client and patient billing payments.
Communicate 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 in resolving 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 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 patient and insurance refund requests; prepare and document refunds for referral to Accounts Payable.
Perform account reconciliation.
Maintain patient and client billing records, collect payments, submit clean insurance claims, and follow up on outstanding balances.
Perform additional duties or assignments as directed by management.