Temporary, Billing Reimbursement Specialist II

Responsibilities

• Focus efforts on increasing cash and reducing bad debt
• Work all incoming correspondence, appeals; review and work accounts to resolution
• Contact Third Party Payers to follow up on claims
• 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
• Communicate problems and trends to leads or supervisors in order to escalate large payer or claims issues and follow through on resolution
• 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
• May have contact with insurance carriers, clients, patients and/or other outside sources
• Able to understand and interpret advice/remark codes from payers
• Create clear and detailed notes within the patients account
• 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
• Regular research involving both the internet and billing systems
• Use of various on and off line methods for following up on outstanding claims
• Ensure billing records are maintained in a confidential manner and in compliance with privacy and documentation procedures
• Meet or exceed daily production standards

Qualifications

• 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
• Problem solving skills, using good judgment, ATTENTION TO DETAIL AND FOLLOW THROUGH ARE A MUST
• Ability to multi-task and work in a fast paced environment without getting distracted
• Self-starter with the ability to work independently but also able to work on a team and take direction
• Excellent customer service skills; excellent verbal and written communication skills
• Ability to work overtime as needed, based on department needs