Revenue Cycle Associate - Collections

Summary

Join BillionToOne, a leading molecular diagnostics company, as a Revenue Cycle/Medical Collections Associate. This remote position reports to the Manager of Reimbursement Operations and focuses on collections and appeals from various payers. You will optimize payment reimbursements, follow up on claims, and process appeals. The ideal candidate possesses extensive experience in medical collections, a deep understanding of healthcare billing, and strong problem-solving skills. BillionToOne offers a competitive salary, excellent benefits including 100% employer-paid medical premiums for select plans, generous parental leave, and a supportive work environment.

Requirements

• Minimum of 4+ years specializing in Medical Collections at a diagnostics company, laboratory or other healthcare provider, doing collections from commercial payers
• Hands-on experience handling the entire appeals process
• Must possess detailed knowledge of all medical benefit levels and have a thorough understanding of Federal, State, & PPO, HMO, and Indemnity Plans structures
• Working knowledge of appropriate coding systems; CPT, ICD-10 and HCPCS, coverage; LCD/NCD and reimbursement associated with such codes
• High School Diploma or a Bachelor’s degree from a four-year college or university
• Strong problem solving skills with ability to streamline and improve processes, use good judgment, attention to detail and follow-through are a must
• Excellent customer service skills; excellent verbal and written communication skills
• Excellent troubleshooting and time management skills, attention to detail, utilizes time in constructive manner
• Ability to easily adapt to increased business demands
• Ability to effectively work with and resolve complex accounts & billing issues
• Self-starter, ability to work independently and be self-motivated to overachieve goals
• Ability to effectively prioritize and multi-task
• Ability to work in fast paced environment, perform under pressure, meet tight timelines
• Establish and maintain cohesive and good working relationships

Responsibilities

• Verify claim was submitted to correct insurance
• Review/update patient demographics and information for accuracy
• Process and validate payor requests and claims via correspondence, remittance advice and EOBs (i.e., identify payment discrepancies, inappropriate requests)
• Investigate all denied services to determine reason and appeal, if appropriate.  Identify and report root causes associated with denials to reduce/resolve issues
• Process assigned appeals including submission, tracking, reporting and evaluation of appeal outcomes (i.e., next steps, improved outcomes)
• Maximize utilization of Billing system, tools and resources to support cash collection activities
• Review various reports including aging outstanding and denial reports
• Comply with Federal and State legislation on all billing related matters
• Comply with all Safety, Emergency, Hazard, OSHA, HIPAA, Quality Assurance and Administrative Plans, Policies, Guidelines, Protocol, and Standards
• Support and maintain department cash and DSO goals

Benefits

• Working with a team of ‘rockstars’ who bring out the best in everyone
• Open, transparent culture that includes weekly Town Hall meetings
• The ability to indirectly or directly change the lives of hundreds of thousand patients
• Multiple medical benefit options; employee premiums paid 100% of select plans, dependents covered at 80%
• Extremely generous Family Bonding Leave for new parents (16 weeks, paid at 100%)
• Retirement savings program including a 4% Company match
• Free daily on-site lunches provided from top eateries
• Latest and greatest hardware (laptop, lab equipment, facilities)
• A variety of perks on campus (state of the art gym, restaurant)
• Free on-site EV charging (compatible with all EVs, including Tesla)
• Competitive base pay
• The opportunity for professional growth
• Industry leading company benefits (free healthcare options, 401k match, very generous fully paid parental leave etc.)