Reconciles medical claims and manages reimbursement for third-party insurance, Medicare, government, and patient billing. Responsibilities include appeals and denial management, medical necessity support, EOB and payer code interpretation, billing inquiry resolution, aging report review, payer assignment, eligibility verification, data entry, and demographic updates. The role also investigates denied services and applies CPT, ICD-10, HCPCS, and payer coverage policies.
Are you motivated to participate in a dynamic, multi-tasking environment? Do you want to join a company that invests in its employees? Are you seeking a position where you can use your skills while continuing to be challenged and learn? Then we encourage you to dive deeper into this opportunity. We believe in career development and empowering our employees.
NeoGenomics is looking for a Billing Reimbursement Specialist II who wants to continue to learn in order to allow our company to grow. This position is a temporary, remote role with a Monday - Friday day shift.
Now that you know what we're looking for in talent, let us tell you why you'd want to work at NeoGenomics:
As an employer, we promise to provide you with a purpose driven mission in which you have the opportunity to save lives by improving patient care through the exceptional work you perform. Together, we will become the world's leading cancer reference laboratory.
Position Summary:
In this position you will be responsible for reconciliation of medical claims for the purpose of collecting revenue for NeoGenomics. They will work with Third Party insurance bills (HMO, PPO, IPA, TPA Indemnity, Medicare, and Government) responsible for processing independent laboratory claims and Patient Billing.
Core Responsibilities:
- Focus efforts on increasing cash and reducing bad debt
- Understands the various NeoGenomics products and tests and can present reasonable arguments for medical necessity on behalf of the patient in order to obtain coverage from the insurance payer
- Appeals and denial management based on payer guidelines in a timely manner
- Knowledge of reading and understanding of EOB’s
- Evaluate and respond to all aspects of written billing inquiries from the patient or their representative in order to resolve billing issues
- Review and work various reports including aging
- Ability to understand and interpret advice/remark codes from payers
- Data entry, correct payer assignment to patient accounts, insurance eligibility verification. Review/update demographics and patient information for accuracy.
- Investigate all denied services to determine the reason for the service denial and take the next appropriate action as necessary
- Additional Responsibilities (may be assigned)
Requirements:
- High School Diploma at minimum required.
- 2 years of experience in A/R, Billing, insurance or healthcare; a background in Laboratory insurance billing preferred
- Working knowledge of appropriate coding systems; CPT, ICD-10 and HCPCS, coverage; LCD/NCD and Payer Medical Policies associated with such codes.
- Proficient in Microsoft Outlook, Excel, Word, the Inter and Intranet and other programs/software as necessary. Working knowledge and hands-on experience of medical billing and reimbursement.
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