Genomics Reimbursement Analyst

CooperSurgical, Inc

Trumbull, CT

Position Summary:

The Genomics Reimbursement Analyst is a member of the CooperGenomics billing team, responsible for billing and collection of clinic, patient, and insurance revenue in an accurate and timely manner while providing exceptional customer service. This individual is responsible for interpretation and proper billing of PGT and Genomic lab tests, maintenance of patient and client billing records, collection of payments for services, submission of “clean” insurance claims, follow-up and resolution of all outstanding balances, responding to customer service inquiries, and performing additional duties or assignments as directed by management.

Essential Functions:

• Front-end Billing
• Accurately bill charges for completed PGT lab tests based on test requisition form and laboratory final report.
• Constant monitoring and updating of lab trackers to reconcile charges and ensure cases are billed as the lab completes them.
• Payment Posting
• Post payments, denials, and correspondence from all sources (ERA, lockbox, mail, credit card processing vendor, collection agency) in the billing system.
• Confirm and reconcile all payments to banking source on a daily basis.
• Accounts Receivables Analysis
• Follow-up on denials and no response insurance claims
• Daily monitoring and resolution of “EP Denial” errors in an accurate, efficient, compliant manner to ensure “clean claim” submission and reduce days in AR
• Research eligibility rejections including contacting of patient to determine current insurance coverage
• Communicate finding of payer trends to Manager
• Research refund requests from patients and insurance; prepare and document refunds for referral to AP.
• Collections for Client and Patient Billing
• Support the processes for past-due collections.
• Pre-collection “soft calls” to patients
• Compilation of accessions which have completed the dunning cycle for referral to outside collections.
• Customer Service
• Assist Client Services team with resolution of patient billing questions (ticketed via ZenDesk system).

Qualifications:

• Qualified candidates must have:
• Ability to work in a fast-paced environment where critical thinking and attention to detail are key.
• Associate degree or equivalent relevant experience
• Healthcare revenue cycle operations experience
• Knowledge of medical billing conventions including (but not limited to) CPT, ICD-10, explanation of benefits, CMS-1500 form and client-style billing.
• Thorough comprehension of the differences between in-network insurance claims and out-of-network insurance claims
• Complex understanding of insurance payor requirements, guidelines, and appeals processes
• Extensive knowledge of patient out-of-pocket expenses including co-pays, deductibles and co-insurances.
• Excellent written and verbal communications skills including the ability to effectively communicate with managers, executives, peers in other departments, patients, IVF clinics and sales personnel
• Computer competencies to include solid grasp of MS Word and above-average skill with MS Excel.
• Reliability, good organization skills, and able to take direction.
• Must be able to maintain confidentiality of data including HIPAA, SOX and other similar regulations.
• Consistently meet deadlines in a fast-paced, changing, and high-tech environment.
• Ability to work collaboratively in a team and build relationships with counterparts in other departments.
• Passing of background check, which may include verification of prior employment, criminal conviction history, educational, and driving records.
• This job requires use and analysis of this type of information:
• Patient billing, financial status, insurance coverage.
• Corporate financial, marketing, or business strategies
• Must be able to work between 6:00 am and 8:00 pm PST, Monday – Sunday
• May be required to work weekends and holidays
• Contact Center Environment; temporarily work from home due to COVID-19
• Must have high speed internet
• Work onsite with possibility of transition to hybrid remote/onsite schedule.

About CooperSurgical:

CooperSurgical is a leader in manufacturing and marketing multiple trusted and innovative brands that assist clinicians in improving the health of women, babies and families worldwide. Through an aggressive growth and diversification strategy, CooperSurgical has evolved its portfolio of over 600 products to include products and services used primarily by obstetricians and gynecologists in surgical and medical procedures wherever they occur: in hospitals, surgical centers, medical offices and fertility clinics.

Our Benefits:

As an employee of CooperSurgical, you'll receive an outstanding total compensation plan. As we believe your compensation goes beyond your paycheck, we offer a great compensation package, medical coverage, 401(k), parental leave, fertility benefits, paid time off for vacation, personal, sick and holidays, and multiple other perks and benefits. Please visit us at www.coopersurgical.com to learn more about CooperSurgical and the benefits of becoming a member of our team.

To all agencies: Please, no phone calls or emails to any employee of CooperSurgical about this opening. All resumes submitted by search firms/employment agencies to any employee at CooperSurgical via-email, the internet or in any form and/or method will be deemed the sole property of CooperSurgical, unless such search firms/employment agencies were engaged by CooperSurgical for this position and a valid agreement with CooperSurgical is in place. In the event a candidate who was submitted outside of the CooperSurgical agency engagement process is hired, no fee or payment of any kind will be paid.

We are committed to equal employment opportunity 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 are proud to be an equal opportunity workplace.