Date Posted: May 12, 2022
Deadline: July 15, 2022
Organization: Greenwood Genetic Center
Website: View Website
Job Type: Full Time
- Strong critical thinking skills
- Self-motivated and self-directed with the ability to work independently and as part of a team
- Ability to maintain strong relationships with physicians, employees, patients, and customers.
- Excellent organizational skills, time management skills and attention to detail
- Proficient in working with computer to include familiarity with Microsoft Office products, Electronic Medical Records and electronic claims software.
- Strong customer service skills to include being comfortable discussing billing issues with both patients and insurance companies
- Excellent verbal and written communication skills
- Prolonged periods of sitting at a desk and working on a computer.
- Must be able to lift up to 15 pounds at times.
The Reimbursement Specialist will be responsible for working with referring providers and/or patients to assist with preauthorization, billing, and reimbursement issues related to genetic testing, visits or consults provided by GGC.
- May assist in training newly hired and established employees in areas related to insurance reimbursement, preauthorization, and collections.
- Perform daily activities of preauthorization submissions, billing, and auditing of accounts to ensure accurate claims submissions and optimization of reimbursement from commercial/governmental payers, clients, and payers for services provided.
- Document eligibility, benefit, and authorization information in accordance with established guidelines.
- Verify prior authorizations and/or pre-service requirements are met.
- Proactively manage and maintain all outstanding authorization accounts to increase billing of clean claims.
- Provide outstanding customer service to patients and develop and maintain positive working relationships with internal and external customers.
- Document all account activity and correspond to inquiries in a timely manner.
- Work as part of the accounts receivable operations to resolve open balances with payers.
- Escalate payer issue trends for leadership consideration along with possible solutions.
- Exhibit a good understanding of genetic services provided, as well as fee practices, with the ability to recognize areas of possible difficulty and take appropriate steps.
- Assist in resolution efforts for payers assigned within the AR department.
- Communicate and work effectively with colleagues from all departments.
- Support training of new and existing personnel specialists with tasks related to the preauthorization and reimbursement function.
- Consistently follow written and verbal communications and internal processes, as well as meet or exceed monthly quality and productivity standards.
- Perform other related duties as assigned.
Education and Experience:
- Bachelor’s degree preferred, with relevant experience in patient billing, preauthorization or insurance verification.
- Demonstrated knowledge of health insurance plans including Medicare, Medicaid, HMO’s and PPO’s beneficial.
101 Gregor Mendel Circle
Greenwood, SC 29646
Our organization does not discriminate on the basis of race, color, religion, national origin, age, sex, sexual orientation, or disability.