Billing Reimbursement Specialist II

Core Responsibilities

• Focus efforts on increasing cash and reducing bad debt
• Understands the various NeoGenomics products and tests and can present reasonable arguments for medical necessity on behalf of the patient in order to obtain coverage from the insurance payer
• Appeals and denial management based on payer guidelines in a timely manner
• Knowledge of reading and understanding of EOB’s
• Evaluate and respond to all aspects of written billing inquiries from the patient or their representative in order to resolve billing issues
• Review and work various reports including aging
• Ability to understand and interpret advice/remark codes from payers
• Data entry, correct payer assignment to patient accounts, insurance eligibility verification
• Review/update demographics and patient information for accuracy
• Investigate all denied services to determine the reason for the service denial and take the next appropriate action as necessary

Additional Responsibilities (may be assigned)

• May be assigned additional duties as needed

Requirements

• High School Diploma at minimum required
• 2 years of experience in A/R, Billing, insurance or healthcare; a background in Laboratory insurance billing preferred
• Working knowledge of appropriate coding systems; CPT, ICD-10 and HCPCS, coverage; LCD/NCD and Payer Medical Policies associated with such codes
• Proficient in Microsoft Outlook, Excel, Word, the Inter and Intranet and other programs/software as necessary
• Working knowledge and hands-on experience of medical billing and reimbursement