Preclaim Data Coordinator I (Temporary)Apply Job ID 2017-5118 Category Commercial Operations Job Location Redwood City, CA Posted Date 10/21/2017
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.
- 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.
- 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
If you want to be part of a team that prides itself in teamwork and developing cutting-edge technology at Genomic Health, apply today!