Careers
Title Reimbursement Specialist
Company Predictive Biosciences
Location Lexington, Massachusetts
Referral Code 103149
Description
Predictive Biosciences is seeking a detail-oriented individual with significant laboratory billing/collection experience, ideally in the molecular diagnostics area, to fill the position of Reimbursement Manager.
The reimbursement managers primary role is to support effective and efficient billing, contracting, accounts receivable and collection functions. In this role, the reimbursement specialist works with PBS employees, and external parties including billing vendor, and customers.
Responsibilities:
Work with external billing company to maximize collection from assigned insurance companies to ensure timely payment and maximum reimbursement
Proactively identify payer issues and work with both internal and external resources to resolve the issues.
Obtain other data elements such as physician NPI number, ICD-9 coding
Organize and forward billing information to outside billing vendor, including assignment of charges for the claim
Perform client verification on OIG
Maintain a reference document for negotiated fee arrangements Maintain a charge entry log for allcases completed, indicating billable vs. non-billable, outside vs. direct billed, etc.
Work closely with laboratory personnel and IT personnel in connection with data maintained in Orchard
Coordinate activities with Laboratory management
Prepare deposits for all remittances
Assist the Finance Department in the overall valuation of net realizable value of accounts receivable
Manage outside billing vendor relative to transactions processed, management reports, and information needs
Assist with credentialing packages and create and manage tracking system for enrollment applications
Qualifications
Must have a minimum of 5 years experience working in medical billing/collections.
Strong customer service and verbal communication skills are a must.
Knowledge of CPT, HCPCS and ICD-9 coding.
Excellent organizational, communication, multitasking and teamwork skills.
Familiarity with billing and medical (laboratory preferred) terminology
Very detail oriented
Appropriate IT skills
Ability to interact with internal staff, vendors, patients and customers excellent people phone skills
Understanding of reimbursement issues and policies, and ability to communicate them effectively
Status
Full-time
Required Education
Not specified
Required Experience
5+ years
Management
Not specified
Travel Requirement
Not specified
Salary Range
$80,000 - $90,000 per year


