Agendia · 4 hours ago
Billing Specialist/Temporary
Irvine,CA,US
Full-time
Onsite
Mid Level
3+ years expAgendia is seeking a Billing Specialist to manage all aspects related to billing, including benefit and eligibility verification and order entry. The role involves generating charges, managing claims, and ensuring proper documentation while collaborating with various departments and external vendors.
BiotechnologyGeneticsHealth CareHealth DiagnosticsLife ScienceMedical
Responsibilities
Primary Billing
QC of order entry in SFDC orders, as well as payor selections
Data entry and transfer daily to the Billing System
Generate charges and electronic claims and print paper claims for various payors requiring paper claim submission
Utilize Sales Force for tasks and logging calls, and follow-up to assigned collectors, prior-authorizations, or Patient Care Specialist
Manage interface errors and upfront claim rejections
Perform other related duties as required or assigned such as overflow work, including word processing, data entry, and internet research tasks
Interface with insurance company representatives, doctor's offices and hospitals regarding the obtainment of medical records, patient demographic and insurance information, and ICD-10 codes
Verification of eligibility and medical benefits utilizing appropriate site or vendor and enter benefit detail in Sales Force
Ensure in verification of coverage criteria depending on payer policy and interact with Customer Care if anything is needed for coverage verification
Utilizes strong analytical skills, including data compilation and attention to detail needed to prepare charges, identify criteria for testing and the ability to request missing information that could hinder a successful claims submission
Uses the chain of command to escalate problems or situations requiring administrative intervention and notifies the Reimbursement Supervisor or Manager when appropriate
Reviews pathology reports and extracts data to determine coverage criteria based on payer policy
Maintain client relationships as it pertains to Benefit and Eligibility duties and contacting patient when requested
Assists in the development of new procedures and systems to enhance productivity
Works directly with Reimbursement Supervisor , Manager, and Director to address and resolve any issues that may affect the Reimbursement Department as a whole
Interacts with the Customer Care team to resolve any tasks and issues that can prevent an order from processing and billing
Qualification
Required
High School diploma or general education degree
CPT and ICD-10 knowledge
Advanced technical knowledge of Microsoft products required (Excel, Word, Outlook)
Must be able to work in a fast-paced environment
Must have strong organizational skills and attention to detail
High degree of accuracy
Manage Multiple tasks independently
General accounting and math skills
Excellent problem resolution
Excellent customer service skills
"Outside the Box" thinker
Analytical thinking
Thoroughness
Good research skills
Strong verbal/written communication
Ability to read and extract information from a path report
Preferred
3+ years related experience preferable
Medical Billing Certification or work experience equivalency
Company
Agendia
Agendia provides molecular diagnostics and personalized treatment plans for cancer patients.
51-200 employees
Funding
Current Stage
Late StageTotal Funding
$182.34MKey Investors
Athyrium Capital Management LPNorgine VenturesDebiopharm Group
2018-07-25Private Equity· $35M
2015-07-01Grant· $4.47M
2014-03-14Debt Financing· $20.87M
Leadership Team
Kurt Becker
Chief Financial Officer
Rene Bernards
Founder and Chief Scientific Officer
Recent News
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