Genomics Billing Specialist

2 weeks ago

Trumbull, Connecticut, United States CooperSurgical Full time
Job Overview
The Genomics Billing Specialist plays a crucial role within the CooperGenomics billing department, tasked with the accurate and timely processing of clinic, patient, and insurance revenue while ensuring top-notch customer service. This position involves the interpretation and precise billing of PGT and genomic laboratory tests, upkeep of patient and client billing records, collection of payments for services rendered, submission of 'clean' insurance claims, follow-up on outstanding balances, addressing customer service inquiries, and undertaking additional responsibilities as assigned by management.
About CooperSurgical
CooperSurgical is a prominent entity in the fertility and women's healthcare sector, committed to enhancing the lives of women, babies, and families during significant healthcare moments. At the forefront of delivering innovative assisted reproductive technology and genomic solutions, CooperSurgical empowers ART professionals to better serve families. The company offers over 600 clinically relevant medical devices to women's healthcare providers, including various testing and treatment options.
CooperSurgical operates as a wholly-owned subsidiary of CooperCompanies (Nasdaq: COO) and is headquartered in Trumbull, CT, providing a diverse range of products and services for women's health care practitioners. More information is available on our website.
Key Responsibilities
  • Billing Operations
  • Ensure accurate billing of charges for completed PGT lab tests based on test requisition forms and laboratory final reports.
  • Continuously monitor and update lab trackers to reconcile charges and ensure timely billing as cases are completed.
  • Payment Processing
  • Record payments, denials, and correspondence from various sources (ERA, lockbox, mail, credit card processing vendor, collection agency) in the billing system.
  • Confirm and reconcile all payments with banking sources daily.
  • Accounts Receivable Management
  • Follow up on denied and unresponsive insurance claims.
  • Daily monitoring and resolution of 'EP Denial' errors to ensure compliant 'clean claim' submissions and reduce accounts receivable days.
  • Investigate eligibility rejections, including contacting patients to verify current insurance coverage.
  • Communicate payer trend findings to management.
  • Research refund requests from patients and insurance; prepare and document refunds for accounts payable referral.
  • Collections Management
  • Support processes for overdue collections.
  • Conduct pre-collection 'soft calls' to patients.
  • Compile accessions that have completed the dunning cycle for referral to external collections.
  • Customer Support
  • Assist the Client Services team in resolving patient billing inquiries (managed via ZenDesk system).
Qualifications
  • Ideal candidates will possess:
  • Ability to thrive in a fast-paced environment where critical thinking and attention to detail are essential.
  • Associate degree or equivalent relevant experience.
  • Experience in healthcare revenue cycle operations.
  • Knowledge of medical billing conventions, including but not limited to CPT, ICD-10, explanation of benefits, CMS-1500 forms, and client-style billing.
  • Comprehensive understanding of in-network versus out-of-network insurance claims.
  • In-depth knowledge of insurance payer requirements, guidelines, and appeals processes.
  • Extensive familiarity with patient out-of-pocket expenses, including co-pays, deductibles, and co-insurances.
  • Excellent written and verbal communication skills, with the ability to effectively engage with managers, executives, peers in other departments, patients, IVF clinics, and sales personnel.
  • Proficiency in MS Word and above-average skills in MS Excel.
  • Reliability, strong organizational skills, and ability to follow directions.
  • Commitment to maintaining confidentiality of data in accordance with HIPAA, SOX, and similar regulations.
  • Ability to consistently meet deadlines in a dynamic, high-tech environment.
  • Capacity to work collaboratively within a team and build relationships across departments.
  • Successful completion of a background check, which may include verification of prior employment, criminal history, educational credentials, and driving records.
  • This role involves the use and analysis of the following information:
  • Patient billing, financial status, and insurance coverage.
  • Corporate financial, marketing, or business strategies.
  • Work is primarily onsite with potential for a hybrid remote/onsite schedule.
As a member of CooperSurgical, you will receive a comprehensive compensation package. We believe that compensation extends beyond your paycheck, offering a robust benefits package, medical coverage, 401(k), parental leave, fertility benefits, paid time off for vacation, personal, sick days, and holidays, along with numerous other perks and benefits. Please visit our website for more information about CooperSurgical and the advantages of joining our team.
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We proudly maintain an equal opportunity workplace.

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