Company: Decipher Biosciences
Location: San Diego
Posted on: January 27, 2023
Job DescriptionSUMMARY: Decipher Biosciences, a subsidiary of
Veracyte, Inc., is a dynamic entrepreneurial startup molecular
diagnostics company focused on cancer genomics. Whether on the
phone with patients, or in the cloud with big data, our innovators
are working hard to give back to the patient what cancer takes
away: information for life.The successful candidate will be a
rockstar at identifying, analyzing and resolving insurance company
denials. While working with our Reimbursement, Commercial and
Finance teams this role will provide on-going insight and analytics
on all medical insurance claims.ESSENTIAL DUTIES AND
RESPONSIBILITIESL: include the following. Other duties may be
- Verifying insurance/recipient eligibility, billing and
follow-up on claims to Medicare, Medicaid and Private Insurer
- Researching and responding to Medicare, Medicaid and other
Payer inquiries regarding billing issues and insurance
- Reviewing unpaid and/or denied claims, appeals and follow-up on
accounts to zero status.
- Organizing and distribute comprehensive appeal packages to the
- Ability to review and interpret explanation of benefits to
determine contractual allowance.
- Researching accounts and resolving deficiencies.
- Calling insurance companies regarding outstanding accounts.
Utilize payor websites to check claim status.
- Reviewing and submitting accurate claims, re-submissions and
claim review forms.
- Researching and monitoring specific billing issues, trends and
potential risks based on current research and customer
- Answering all patient/doctor/hospital/lab/insurance company
phone calls regarding accounts, and takes appropriate action.
- Providing administrative support (when requested) including
performing data entry, updating various record keeping systems,
upholding company policies and Client requirements, and
participating in projects, duties, and other administrative
- Knowledge, understanding, and compliance with all applicable
Federal and Local laws and regulations relating to job duties.
- Knowledge, understanding, and compliance with Company policies
and procedures.REQUIREMENTS: QUALIFICATIONSTo perform this job
successfully, an individual must be able to perform each essential
duty satisfactorily. The requirements listed below are
representative of the knowledge, skills and/or abilities required.
Reasonable accommodation may be made to enable individuals with
disabilities to perform the essential functions.EDUCATION and/or
- A university degree or a Certified Professional Coder or 2 yr
Degree from Accredited Medical Billing School
- 3-5 Years of direct appeals and billing experience
- Enthusiasm and an entrepreneurial spirit
- Familiarity with ICD and HCPC/CPT coding preferred
- Familiarity with CMS 1500 claim form preferred
- Familiarity with Claim Adjustment Reason Codes (NUCC)
- Use of personal computer, computer applications, and general
office equipment including scanners.
- Ability to create and maintain spreadsheets
- Ability to use analytical, interpersonal, communication,
organizational, numerical, and time management skills.
- Experience 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
- 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.PHYSICAL REQUIREMENTS
- Repetitive movement of hands, arms and legs
- Repetitive movement of fingers (typing and/or writing)
- Sitting, with occasional walking, standing, stooping and moving
- Exposure to general office environment conditions
- Talking and hearing
- Occasionally required to lift up to 25 poundsEqual Opportunity
Employer: All qualified applicants will receive consideration for
employment without regard to race, color, religion, sex, sexual
orientation, gender identity, national origin, disability, or
status as a protected veteran.Powered by JazzHRTE6Ff9wYOkby
Keywords: Decipher Biosciences, San Diego , Reimbursement Specialist, Other , San Diego, California
Didn't find what you're looking for? Search again!