Reimbursement Specialist

🔥 13 hours ago

🇺🇸 United States – Remote

💵 $24 - $33 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Veracyte, Inc.

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

🏥 Healthcare

🧬 Biotechnology

⚕️ Healthcare Insurance

Healthcare • Biotechnology • Healthcare Insurance

Veracyte, Inc. is a genomic diagnostics company focused on empowering clinicians with high-value molecular tests for diagnosing and treating cancer. The company provides a portfolio of genomic classifiers for various types of cancer, including thyroid, prostate, lung, breast, and bladder cancer, as well as interstitial lung disease. Veracyte's tests help clinicians and patients make informed decisions about cancer care by providing clear diagnostic and prognostic insights. The company's approach involves identifying unmet clinical needs and developing high-performance tests that are widely accessible globally through a CLIA and in vitro diagnostic-based model. Committed to elevating the standard of cancer care, Veracyte continues to expand its test portfolio and make significant contributions to the field of oncology diagnostics.

📋 Description

• Research and monitor billing issues, trends, and potential risks • Review claims and ensure accurate submission with all pre-claim requirements • Track claim status and pull reports, especially in Excel • Review denied or unpaid claims and take corrective action, including resubmission and appeals • Provide administrative support, including data entry and updating record-keeping systems • Navigate payer portals, websites, and phone systems to check eligibility, prior authorization, claim, and appeal statuses • Apply payer guidelines and policies to daily decision-making • Assist patients with their financial journey • Verify insurance and recipient benefits with Medicare, Medicaid, and private insurers • Complete billing responsibilities accurately and timely each day • Review and interpret explanations of benefits • Collaborate with insurance companies, internal teams, customers, and patients to support timely reimbursement

🎯 Requirements

• High school diploma or GED • Associate's or bachelor's degree in healthcare administration, business, or related field preferred • Use of personal computer, computer applications, and general office equipment • Experience with Microsoft Office, especially Word and Excel • 2+ years of experience in medical billing, insurance claims, or revenue cycle operations • Experience with payer portals and claim tracking systems • Familiarity with HIPAA compliance and healthcare privacy regulations • Experience working with CRMs such as Salesforce and billing software such as Epic, XiFin, and Quadax • Ability to use analytical, interpersonal, communication, organizational, numerical, and time management skills • Ability to meet deadlines and manage several projects at a time • Familiarity with ICD and HCPCS/CPT coding preferred • Familiarity with CMS 1500 claim form preferred • Familiarity with Claim Adjustment Reason Codes (NUCC) preferred

🏖️ Benefits

• Competitive compensation and benefits • Potential eligibility for additional discretionary bonuses/incentives • Potential eligibility for restricted stock units • Career opportunities • Inclusive workforce and workplace