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    Account Manager - Molecular Genetics - Billing/Revenue Cycle Mgt

    Tesis Labs Llc
    1-5 years
    $65,000 to $85,000 per year
    Remote, USA
    10 Oct. 24, 2024
    Job Description
    Job Type: Full Time Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

    Tesis Laboratory is seeking a billing professional to join our team. This position offers the flexibility of remote work.

    Position Overview:

    As a Billing Professional, you will be responsible for managing all aspects of molecular genetic laboratory billing and revenue cycle management. This includes thorough insurance benefit investigations for new referrals, a small assignment of collections with various payers, authorization requests, and claim submissions.

    Essential Duties:

    • Accurately interpret patient insurance, prescriptions, and other health-related documentation.
    • Conduct medical insurance verification and investigations for commercial and government payors.
    • Communicate with insurance companies, patients, providers, and prescribers to coordinate reimbursement and access solutions.
    • Review unpaid accounts to determine status and take appropriate actions to ensure payment.
    • Ensure compliance and completeness of all claims before submission.
    • Research alternative funding options to alleviate patient financial burdens.
    • Maintain a high degree of confidentiality due to access to sensitive information.
    • Demonstrate regular, predictable, and consistent attendance while being flexible to meet departmental needs.
    • Collaborate with customers and affiliates on reporting, best practices, and strategic planning to optimize growth in a compliant environment.
    • Review and design KPIs to ensure proper financial performance of assigned laboratory clients.
    • Adhere to all Medicare, Medicaid, and HIPAA regulations and requirements.
    • Follow all regulations, policies, procedures, and standards.

    Position Requirements & Competencies:

    • High school diploma or equivalent required; undergraduate degree preferred.
    • Required experience in Genetic Lab Billing, Accounts Receivables, and/or Collections within a healthcare or insurance environment.
    • Proficiency in MS Office and web-enabled applications strongly preferred.
    • Strong customer service skills required.
    • Understanding of Medicaid, Medicare, and insurance billing requirements for genetic laboratories in all MACs required.
    • Minimum of 5 years of experience in laboratory medical billing.
    • At least 3 years of experience with Cancer Genomics billing.
    • Minimum of 1 year of experience with R&D of molecular genetics panels.
    • Certified Medical Coder or Biller with AHIMA or an affiliated organization preferred.
    • Experience managing clients and/or employees is a plus.

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