Skip Navigation

Search Jobs

Search

Search All Openings
Hero Image

Preclaim Data Coordinator I (Temporary)

Apply Share Job ID 2017-5118 Category Commercial Operations Job Location Redwood City, CA Posted Date 10/21/2017

Overview:

Billing & Reimbursement: Clinical criteria and pre-claim documentation preparation to help facilitate internal payer claim support activities.  Correlate order intake detail to complete Patient insurance verifications and benefit inquiries.  Determine appropriate Prior auth, Pre-claim and other reimbursement related requirements for Oncotype assay orders. Communicate with internal cross functional related groups and external parties for enhanced order to claim workflow.

Responsibilities:

  • Maintain ongoing tracking and appropriate documentation on referrals
  • Ensure complete and accurate patient demographic and insurance information. 
  • Assemble patient's clinical case info and determine referral needs, based on payer guidelines, and Identify missing clinical information. 
  • Create case communication to ensure prior approval requirements are met.
  • Facilitate process flow for necessary medical information, provide specific follow up to and directions on     completing pre-claim activities to support reimbursement and improve clean claim initiatives
  • Be the systems navigator and point of contact for the internal management team to ensure approvals communication of the necessary services for the patient case in a timely fashion.

Qualifications:

  • 2-4 years’ service billing/collections experience within the provider setting
  • Knowledge of and/or experience with public & private Managed Care payers and claims reimbursement process
  • Effective communication skills, both written and oral across internal and external personnel –
  • Collaborative and works effectively as a team member
  • Strong attention to detail and organizational skills
  • Knowledge claims EDI and coding is a plus
  • Good judgement and problem-solving skills
  • Able to take and follow through with delegated tasks and accountability
Apply Share

If you want to be part of a team that prides itself in teamwork and developing cutting-edge technology at Genomic Health, apply today!