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Benefits Coordinator

Company: Veracyte
Location: San Diego
Posted on: January 26, 2023

Job Description:

The Position:

The successful candidate will excel at identifying, analyzing, and resolving insurance eligibility issues, as well as successfully submitting Prior Authorizations and routing their approvals and/or denials appropriately. Benefits Coordinator will be working with our Reimbursement, Commercial, and Finance teams to provide on-going insight and analytics on all medical insurance claims.

Responsibilities include the following:

  • Answering patient/doctor/hospital/lab/insurance company phone calls regarding accounts and taking appropriate action.
  • Calling insurance companies regarding eligibility and authorization.
  • Correctly identifying insurance carrier for proper claims filing.
  • Creating and maintaining spreadsheets.
  • Reviewing and interpret explanation of benefits to determine contractual allowance.
  • Utilizing payor websites to check claim status and contacting payors regarding outstanding accounts
  • Efficiently and accurately submitting Prior Authorization requests to insurance carriers via paper request and/or electronically (Glidian).
  • Ensuring accurate and timely billing entry is completed daily.
  • Researching and monitoring specific billing issues, trends and potential risks based on current research and customer feedback.
  • Researching and responding to Medicare, Medicaid and other Payer inquiries regarding billing issues and insurance updates.
  • Reviewing and submitting accurate claims, re-submissions and claim review forms.
  • Reviewing unpaid and/or denied claims, appeals and follow-up on accounts to zero status.
  • Reviewing and evaluating patient demographics for appropriate handling to include initiating telephonic follow-up to appropriate parties to collect additional information required for account resolution and/or to confirm account, claim status and arrange payment.
  • Verifying insurance/recipient eligibility on to Medicare, Medicaid and Private Insurer Payers.
  • When requested, providing administrative support for department(s) including but not limited to performing data entry, updating various record keeping systems, upholding company policies and Client requirements, and participating in projects, duties, and other administrative tasks.
    Who You Are:
    • You have a 4-year College degree, Certified Professional Coder or 2-year degree from an Accredited Medical Billing School is highly preferred.
    • 3-5 Years of direct verification and billing experience is required.
    • Familiarity with ICD and HCPC/CPT coding preferred.
    • Familiarity with CMS 1500 claim form preferred.
    • Familiarity with Claim Adjustment Reason Codes (NUCC) preferred.
    • Use of personal computer, computer applications, and general office equipment including scanners. Ability to create and maintain spreadsheets.
    • Experience in handling and expediting escalated issues, with follow up to the customer.
    • Ability to quickly assess a situation and take appropriate actions to address customer needs and requests in a timely and efficient manner. Self-starter with the ability to work independently and effectively in a team environment.
    • Ability to organize and prioritize multiple projects/tasks and meet deadlines in a constantly evolving and fast-paced environment.
    • Strong, consistent work ethic with a keen attention to details and ability to focus on the big picture.
    • Excellent written and verbal communication skills; must be able to communicate with confidence and tact across all levels within the company.
    • Ability to use analytical, interpersonal, communication, organizational, numerical, and time management skills.
      What We Can Offer You:

      Veracyte is a growing company that offers significant career opportunities if you are curious, driven, patient-oriented and aspire to help us build a great company. We offer competitive compensation and benefits, and are committed to fostering an inclusive workforce, where diverse backgrounds are represented, engaged, and em powered to drive innovative ideas and decisions. We are proud to have been named a "Bay Area Top Workplace" for nine years in a row by the Bay Area News Group, based solely on employee feedback.

      The anticipated base salary range for candidates who will work in San Diego, California is $25 to $26 per hour. The final salary offered to a successful candidate will be dependent on several objective factors that may include, but are not limited to, the type and length of experience within the job, type and length of experience within the industry, education, etc. Base pay is one part of the Total Compensation and Benefits Package that is provided to compensate and recognize employees for their work, and this role may be eligible for additional discretionary bonuses/incentives, and restricted stock units.

      Veracyte is a multi-state employer, and this salary range may not reflect positions that are located in areas outside of the designated location in this posting.

Keywords: Veracyte, San Diego , Benefits Coordinator, Other , San Diego, California

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