Account Manager - Molecular Genetics - Billing/Revenue Cycle Mgt

Job Description

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:

1. High school diploma or equivalent is required; Undergraduate degree is preferred.
2. Experience in Genetic Lab Billing, Accounts Receivables, and/or Collections within a healthcare or insurance environment is required.
3. Computer proficiency -- MS Office and Web-enabled applications strongly preferred
4. Customer service skills required.
5. Understanding of the requirements of Medicaid, Medicare, and Insurance billing for genetic laboratories in all MAC’s is required.
6. 5 years’ experience with Laboratory medical billing.
7. 3 years minimum with Cancer Genomics billing.
8. 1 year with R & D of molecular genetics panels.
9. Certified Medical coder or biller with AHIMA or affiliated organization.
10. Experience with managing clients and/or employees preferred.