Account Manager - Molecular Genetics - Billing/Revenue Cycle Mgt

Job Description

Tesis Laboratory is seeking a billing professional. Remote work is available.

This position is responsible for all molecular genetic laboratory billing and revenue cycle management, thorough insurance benefit investigation of new referrals, a small assignment of collections with a variety of payers, authorization requests, and claim submission.

ESSENTIAL DUTIES:

Accurately interprets patient insurance, prescription, and other health-related documentation.

Conducts medical insurance verification and investigations for commercial and government payors.

Communicates with insurance companies, patients, providers, and prescribers to coordinate reimbursement and access solution.

Reviews unpaid accounts to determine status and taking appropriate action to ensure payment.

Reviews all claims for compliance and completeness for claims submissions.

Researches available alternative funding options to reduce patient's financial burden

Always maintains a high degree of confidentiality due to access to sensitive information.

Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department.

Works with customers and affiliates on reporting, best practice, and strategic planning to optimize growth within a compliant environment.

Reviews and designs KPI to ensure proper financial performance of assigned Laboratory clients.

Follows all Medicare, Medicaid, and HIPAA regulations and requirements.

Abides by all regulations, policies, procedures, and standards.

POSITION REQUIREMENTS & COMPETENCIES:

High school diploma or equivalent is required; Undergraduate degree is preferred.

Experience in Genetic Lab Billing, Accounts Receivables, and/or Collections within a healthcare or insurance environment is required.

Computer proficiency -- MS Office and Web-enabled applications strongly preferred

Customer service skills required.

Understanding of the requirements of Medicaid, Medicare, and Insurance billing for genetic laboratories in all MAC’s is required.

5 years’ experience with Laboratory medical billing.

3 years minimum with Cancer Genomics billing.

1 year with R & D of molecular genetics panels.

Certified Medical coder or biller with AHIMA or affiliated organization.

Experience with managing clients and/or employees preferred.