Reimbursement Specialist - Customer Support

Reimbursement Specialist – Customer SupportAbout UsWould you like to be part of a fast-growing team that believes no one should have to succumb to viral-mediated cancers? Naveris, a commercial-stage precision oncology diagnostics company with facilities in Boston, MA and Durham, NC, is looking for a Reimbursement Specialist – Customer Support team member to help us advance our mission of developing and delivering novel diagnostics that transform cancer detection and improve patient outcomes. Our flagship test, NavDx, is a breakthrough blood-based DNA test for HPV cancers, clinically proven and already trusted by thousands of physicians and institutions across the U.S.OpportunityWe are looking for a conscientious, knowledgeable individual to join our team and support the varied aspects of the reimbursement process. While Naveris partners with an outsourced RCM vendor, this role will provide additional oversight and direct involvement, including reviewing claim submissions, supporting appeals, and communicating with payers, providers, and patients across Medicare, Medicaid, and commercial insurance plans.Job ResponsibilitiesHandle inbound and outbound calls, faxes, and emails, determining appropriate next steps and resolutions.Communicate clearly and empathetically with patients and providers regarding billing policies, EOBs, financial assistance programs, and member responsibility.Explain insurance-related processes to patients and address non-clinical billing questions.Critically assess complex or sensitive situations and, when appropriate, rise to leadership.Understand and communicate the reimbursement process from intake through resolution.Deliver a high level of customer service while managing multiple concurrent priorities.Utilize internal systems, tools, and vendor resources to support reimbursement activities.Ensure compliance with Federal and State regulations, including HIPAA and PHI handling.Work cross-functionally with the CLIA lab, Patient Navigation and Clinical Operations teams to ensure a best-in-class customer and patient experience.Fully remote role (U.S.-based) with occasional travel for trainings, meetings, or on-site presence at headquarters.Travel requirement: up to 5%.Qualifications4+ years of experience in reimbursement or revenue cycle management within a diagnostics company, laboratory, or commercial payer environment.Bachelor's degree or equivalent experience.Experience with Xifin, Quadax, or Telcor preferred.Strong knowledge of medical benefit structures, including Federal, State, PPO, HMO, and indemnity plans.Working knowledge of CPT, ICD-10, and HCPCS coding, as well as LCD/NCD coverage and reimbursement guidelines.Strong problem-solving skills with attention to detail and follow-through.Excellent verbal and written communication skills; strong customer service orientation.Effective time-management skills and ability to adapt in a fast-paced environment.Self-starter who can work independently and manage competing priorities.Compliance ResponsibilitiesHealth Insurance Portability and Accountability Act (HIPAA) is a federal law that describes the national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge. All roles at Naveris require compliance with legal and regulatory requirements of HIPAA and acceptance and adherence to all policies and standards at Naveris. Personnel acknowledge they are personally responsible for reporting any suspected violations or abuse and are required to complete HIPAA training when joining the company.Why NaverisIn addition to our great team and advanced medical technology, we offer our employees competitive compensation, work/life balance, remote work opportunities, and more!Equal Opportunity EmployerNaveris is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We don't just accept differences – we celebrate and support them. We do not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.J-18808-Ljbffr Naveris, Inc.