Reimbursement Specialist
4 days ago
CareDx, Inc. is seeking a highly skilled Reimbursement Specialist to join our team. As a key member of our organization, you will play a critical role in ensuring timely and accurate payment for our patients.
Responsibilities- Verify patient insurance coverage and benefits by contacting insurance companies or using electronic verification tools.
- Review insurance policies to determine what services are covered, including deductibles, co-payments, and coverage limits.
- Accurately input patient and insurance information into billing systems and insurance billing tools.
- Submit authorization requests to insurance companies or other payers for approval of medical services or procedures.
- Interact with internal teams, healthcare providers, insurance companies, and patients to gather necessary information and facilitate the authorization process.
- Ensure all authorizations adhere to government, regulatory, and payer guidelines and standards.
- Identify and address issues related to denied or delayed authorizations and develop strategies to mitigate these problems.
- Keep detailed records of eligibility verification and communications with insurance companies.
- Monitor the status of authorization requests and follow up with insurance companies to ensure timely processing and approval.
- Explain laboratory insurance benefits, coverage, policy requirements, and filing rules to patients.
- High School Diploma or equivalent.
- Proficiency in medical terminology, healthcare billing codes (CPT, HCPCS, ICD), and payer policies.
- Proficiency with healthcare management software, claims processing systems, Electronic Health Records (EHR), Electronic Medical Records (EMR), and insurance websites.
- Understanding of regulatory compliance and insurance reimbursement processes.
- Previous experience in healthcare billing, coding, claims processing, particularly in diagnostic laboratory services, is highly valued.
CareDx offers a competitive Total Rewards package, including a base salary, incentive compensation, health and welfare benefits, 401(k) savings plan match, and employee stock purchase plan. We also have a Living Donor Employee Recovery Policy that allows up to 30 days of paid leave annually to a full-time employee who makes the selfless act of donating an organ or bone marrow.
We are an Equal Opportunity Employer and participate in the E-Verify program. By proceeding with our application and submitting your information, you acknowledge that you have read our U.S. Personnel Privacy Notice and consent to receive email communication from CareDx.
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