Senior Revenue Cycle Specialist

About UsInform Diagnostics, a Fulgent Genetics Company, is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology.Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a premier, full-service genomic testing company built around a foundational technology platform.Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can redefine the way medicine is managed for patients and clinicians alike.Since integrating with our therapeutic development business, Fulgent is also developing drug candidates for treating a broad range of cancers using a novel nanoencapsulation and targeted therapy platform. By merging our fields of expertise, we aim to become a fully integrated precision medicine company.Summary of Position**This is a hybrid on-site position at our office in Coppell, TX. Per current policy, the first 90 days of employment will require fully on-site attendance. After successful completion of the probationary period, new hires may transition to a hybrid schedule of 3 days on-site per week. This policy is subject to change at the discretion of Inform Diagnostics executive leadership.**Position Description:Senior Revenue Cycle Specialists are responsible for problem resolution and payment collection of complex billing transactions. Utilizes expert problem-solving skills to resolve complex billing issues, unpaid claims, and customer complaints, taking all steps and coordinating corrective action of a multi-functional nature to ensure full resolution of prompt payment.Key Job ElementsHandles correspondence related to insurance or patient account, contacting insurance carriers as needed to get maximum payment on accounts and identify issues and corrective action to be taken.Identifies trends taking action to help prevent reimbursement issues and delinquent accounts. Utilize the identified trends and pattern recognition to identify defects and eliminate them at the source. Collaborate with leadership and other key stakeholders to make solution recommendations.Utilizes expert problem-solving skills to resolve complex billing issues, unpaid claims, and customer complaints, taking all steps and coordinating corrective action of a multi-functional nature to ensure full resolution of prompt payment.Examines all documents to ensure bills are compliant. Determines appropriate steps and communicates critical information to insurance companies, patients, and leadership both verbally and in writing, to ensure concerns are resolved in a timely manner and accounts are settled in full.Communicates with carriers, patients, and management of all levels as needed to get maximum payment/resolution on accounts and identifies/resolves issues or changes to achieve profitability.Acquires knowledge of payor fee schedules and denials.Demonstrates in-depth understanding of Medicare, Medicaid and private payors, policies and guidelines.Researches and resolves denials making appropriate decisions on accounts to maximize reimbursement.Works aging reports of unpaid claims to resolve claims.Works complex projects and assignments requiring advanced knowledge and experience in insurance accounts receivable.Assists as needed to perform other related duties and special projects as required.Knowledge/ExperienceHigh School Diploma or GED.Minimum 4 years’ experience in complex healthcare billing reimbursement environment.Advanced knowledge of government and private payor reimbursement required.Anatomic pathology or diagnostic laboratory experience a plusDemonstrated interpersonal skills. The role will require interaction with a wide range of fellow employees, clients, and other internal and external stakeholders.Maintain a high standard of discipline and professionalism.Ability to think creatively and initiate new ideas or solutions to business issues.Demonstrated commitment, self-motivation, and drive.Ability to work in a fast paced and deadline driven environment.Supervisory Responsibilities:• NoneReports To:• Senior Manager Revenue Cycle ManagementEnvironmentFulgent Therapeutics LLC is an Equal Employment Opportunity Employer.The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. The term “qualified individual with a disability” means an individual with a disability who, with or without reasonable accommodation, can perform the essential functions of the position.This job description reflects management’s assignment of essential functions. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.Please note that Fulgent (and its affiliated companies, including Inform Diagnostics and CSI Laboratories) does not accept unsolicited information and/or resumes from search firms or agencies for our job postings. Search firms or agencies without an applicable contract and/or express approval to recruit for the role in question — that choose to submit a resume or client information to our career page or to any employee of Fulgent — will not be eligible for payment of any fee(s), and any associated shared data will become the property of Fulgent. #J-18808-Ljbffr