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Genomics Billing Specialist
2 months ago
The Genomics Billing Specialist plays a crucial role within the CooperGenomics billing department, focusing on the accurate and timely billing and collection of clinic, patient, and insurance revenues while ensuring exceptional customer support. This position involves interpreting and accurately billing for PGT and genomic laboratory tests, maintaining comprehensive billing records for patients and clients, collecting payments for services rendered, submitting precise insurance claims, and following up on outstanding balances. Additionally, the role includes addressing customer service inquiries and executing other tasks as assigned by management.
About CooperSurgical
CooperSurgical is a prominent organization in the fertility and women's healthcare sector, committed to enhancing the lives of women, babies, and families during critical healthcare moments. The company leads in providing innovative assisted reproductive technology and genomic solutions that support ART professionals in their mission to assist families. CooperSurgical 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 based in Trumbull, CT, where it develops and markets a diverse range of products and services for women's health care practitioners. More information can be found at .
Key Responsibilities
- Billing Management
- Ensure accurate billing of charges for completed PGT laboratory tests based on requisition forms and final laboratory reports.
- Continuously monitor and update laboratory trackers to reconcile charges and guarantee timely billing as cases are completed.
- Payment Processing
- Record payments, denials, and correspondence from various sources (ERA, lockbox, mail, credit card processing vendors, collection agencies) in the billing system.
- Confirm and reconcile all payments with banking sources daily.
- Accounts Receivable Oversight
- Follow up on denied and unresponsive insurance claims.
- Monitor and resolve 'EP Denial' errors efficiently to ensure clean claim submissions and minimize 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 for Client and Patient Billing
- 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 a ticketing system).
- Ideal candidates will possess:
- The ability to thrive in a fast-paced environment where critical thinking and attention to detail are essential.
- An associate degree or equivalent relevant experience.
- Experience in healthcare revenue cycle operations.
- Knowledge of medical billing practices, including but not limited to CPT, ICD-10, explanation of benefits, CMS-1500 forms, and client-style billing.
- A thorough understanding of the distinctions between in-network and out-of-network insurance claims.
- A complex understanding of insurance payer requirements, guidelines, and appeals processes.
- Extensive knowledge of patient out-of-pocket expenses, including co-pays, deductibles, and co-insurances.
- Excellent written and verbal communication skills, with the ability to effectively interact with managers, executives, peers in other departments, patients, IVF clinics, and sales personnel.
- Proficiency in computer skills, including a solid understanding of MS Word and above-average proficiency in MS Excel.
- Reliability, strong organizational skills, and the ability to follow directions.
- The capacity to maintain confidentiality of data in accordance with HIPAA, SOX, and similar regulations.
- The ability to consistently meet deadlines in a dynamic, high-tech environment.
- A collaborative spirit and the ability to build relationships with colleagues across departments.
- Successful completion of a background check, which may include verification of prior employment, criminal history, educational background, and driving records.
- This position involves the use and analysis of information related to:
- Patient billing, financial status, and insurance coverage.
- Corporate financial, marketing, or business strategies.
- Work onsite with the potential for a hybrid remote/onsite schedule.
We are dedicated to equal employment opportunities 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 take pride in being an equal opportunity workplace.
