Medical Accounts Receivable Specialist

2 weeks ago

San Diego, United States Hologic Full time

Biotheranostics provides comprehensive and proprietary diagnostic solution for metastatic cancer. The company discovers, develops,
and commercializes diagnostic, prognostic, and predictive tests that drive personalized cancer treatment. The company operates a CLIA-certified diagnostic service laboratory in San Diego, CA.

**Overview**:
Under general supervision and with a high level of knowledge, skills and experience, Accounts Receivable Specialist performs a variety and full range functions related to Biotheranostics customer service, billing, appeals and accounts receivable resolution.
Functions include but are not limited to billing, Third Party Payer follow-up, trend and A/R analysis, account inquiry resolution and appeals. In addition to specific duties, position may assist in other areas as needed to minimize risks related to achieving financial performance.

**Primary Responsibilities**:

- Timely, effective follow up and maximize collection of assigned Third Party Payer outstanding A/R and denials.
- Analysis and timely reporting related to Third Party Payer A/R, denials and overall payer performance.
- Trend, payer issue, cash flow disruption identification, tracking, reporting and resolution
- Identify, report root causes associated with denials.
- Processing, validation of payer requests and processed claims via correspondence, remittance advice and EOBs (i.e. Identification of payment discrepancies, inappropriate requests).
- Timely, effective processing of assigned appeals including development, submission, tracking, reporting and evaluation of appeal outcomes (i.e. next steps, improved outcomes).
- Maximize utilization of Billing system, tools and resources to support cash collection activities.
- Keep current with all payer regulations, guidelines and provider/payer contract terms
- Effectively manage incoming calls, resolve internal and external customer inquiries regarding all aspects of patient and/or client accounts.
- Support and maintain department cash and DSO goals.
- Data entry, correct insurance assignment to patient accounts, insurance eligibility verification. Review/update demographics and patient information for accuracy.
- Performs additional tasks, projects, special assignments as required Qualifications:

- High school diploma (or GED equivalent).
- Minimum 5 plus years’ experience
- all aspects of patient account management and resolution with an emphasis in Third Party Payers, A/R and denial resolution, preferably in a laboratory environment.
- Must be able to demonstrate strong knowledge of commercial and government health plan requirements, guidelines, billing practices and regulations.
- Ability to effectively work with and resolve complex accounts & billing issues.
- Excellent troubleshooting and time management skills, attention to detail, utilizes time in constructive manner.
- Ability to work in fast paced environment, perform under pressure, meet tight time lines
- Establish and maintain cohesive and good working relationships.
- Excellent communication and customer service skills; cooperative, work collaboratively and treat others in respectful, professional and supportive manner.
- Working knowledge of ICD-10, CPT, LCD/NCD and reimbursement associated with such codes.
- Ensures compliance with all state and federal billing an HIPAA regulations.
- Strong knowledge and experience with Microsoft Excel as well as Word and Outlook, general office equipment, ten key by touch.

**So why join Hologic?**

We are committed to making Hologic the company where top talent comes to grow. For you to succeed, we want to enable you with the tools and knowledge required and so we provide comprehensive training when you join as well as continued development and training throughout your career. We offer a competitive salary and annual bonus scheme, one of our talent partners can discuss this in more detail with you.

The annualized base salary range for this role is $47,500- $71,200 and is bonus eligible. Final compensation packages will ultimately depend on factors including relevant experience, skillset, knowledge, geography, education, business needs and market demand.

Hologic, Inc. is proud to be an Equal Opportunity Employer inclusive of disability and veterans

Pay: $47,500.00 - $71,200.00 per year

**Benefits**:

- Employee discount
- Health savings account
- Retirement plan
- Tuition reimbursement

Schedule:

- No weekends

Work setting:

- Hybrid work

Work Location: Hybrid remote in San Diego, CA 92121

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