Sr. Billing Specialist

4 weeks ago

Fremont, California, United States Personalis Full time

At Personalis, we are transforming the active management of cancer through breakthrough personalized testing. We aim to drive a new paradigm for cancer management, guiding care from biopsy through the life of the patient. Our highly sensitive assays combine tumor-and-normal profiling with proprietary algorithms to deliver advanced insights even as cancer evolves over time. Our products are designed to detect minimal residual disease (MRD) and recurrence at the earliest timepoints, enable selection of targeted therapies based on ultra-comprehensive genomic profiling, and enhance biomarker strategy for drug development. Personalis is based in Fremont, California.

Summary:

The Billing Specialist will be a critical component to Personalis' 2024 business goals. This role will increase billing and collection efforts and ensure expediency in the processing of Next Personal DX payments. Through the management and maintenance of the payer database and accuracy of posting receipts, the Billing Specialist ensures the accuracy of the order intake process, submission of clean claims and the application and reconciliation of receipts. The role also serves to build and reinforce existing relationships with payers, clients and patients.

Who You Are
You have extensive knowledge about the medical billing and the revenue cycle management process. You have a firm grasp on client and third-party billing, payer structures, claims processing and reimbursement requirements. You are known for your strong attention to detail and ability to reconcile daily payment transactions within the backdrop of CPT usage and ICD-10 coding.
Additionally, you enjoy investigating and using your analytical skills to effectively problem solve. Your passion to troubleshoot issues and discrepancies is demonstrated through a proven track record of resolving claim rejections, denials and working with insurance carriers, clearinghouses and payers to obtain information and potential reimbursement. You leverage your MS Excel skills by using formulas and pivot tables to summarize payer enrollment and payment data. You are also able to navigate across various computer applications and payer portals. You are known for excellent customer service and can communicate effectively to customers in both written and verbal formats. Contributing to a team environment is something you enjoy; including learning from others, vocalizing potential customer or systems issues during team meetings, and communicating ideas for continual business improvement.

Hybrid: Onsite on Mon, Tue & Thu

Responsibilities:

  • Collect and review patient information needed to complete the billing process
  • Request any missing patient information
  • Transfer insurance claims and billing data to billing software
  • Verify patient benefits and insurance
  • Maintain an up-to-date list of current insurance providers
  • Develop and maintain a tracking system of incoming and late payments
  • Initiate late payment notices to relevant parties
  • Respond to questions and complaints from patients or insurance companies
  • Follow-up on registration errors and insurance denials
  • Demonstrate a balance of persistent follow-up and decorum on late or unpaid claims
  • Identify trends of claims not paid by insurance providers and/or patients and solve issues
  • Arrange payment plans and timelines for payments
  • File and maintain organized documentation of all billing and record
  • Follow SOPs on billing processes and procedures
  • Update and review all accounts to keep records of payments up-to-date
  • Work with Client Experience, Finance, Sales, and Lab Operations to ensure revenue integrity
  • Engage with payer and request prior authorization for tests
  • Post receipts and payments on Xifin
  • Support activities related to integrating the billing system with LIMs and other IT systems.

Qualifications:

  • High school diploma or equivalent GED. BS/BA preferred.
  • A minimum of 5 years of experience with billing software, medical insurance regulations, and responding to insurance and patient inquiries
  • Exceptional phone etiquette to communicate with patients and physicians
  • Able to multitask, prioritize, and manage time efficiently
  • Self-motivated and self-directed; able to work without supervision
  • Proficient computer skills, Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel); working knowledge of billing software (XIFIN) is a plus
  • Able to analyze problems and strategize for better solutions

The hiring range for this position is $31.25 to $37 per hour, which may factor in various geographic regions. The base pay actually offered will take into account internal equity and also may vary depending on the candidate's geographic region, job-related knowledge, skills, and experience among other factors. Our full-time regular positions also include an annual performance-based bonus (or a sales incentive plan) and long-term incentive units (equity) provided as part of our compensation package, in addition to a full range of medical, financial, and/or other benefits, dependent on the level and position offered.

Personalis is an equal opportunity employer and is committed to the full inclusion of all individuals. As part of this commitment, Personalis will ensure that persons with disabilities are provided with reasonable accommodations. If you need an accommodation to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please let your recruiter know, if/when they contacts you.

Personalis is an Equal Opportunity Employer/Minorities/Females/Veterans/Disabilities. Personalis offers a competitive compensation package and benefits including medical, dental, vision, 401(k) match, ESPP, tuition reimbursement, sick/vacation time, commuter benefits/ EV charging stations, onsite gym, and wellness benefits. (For US only, benefits in other countries may vary.)

#LI-Hybrid #LI-KK1

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