Genomic Health, Inc. Preclaim Data Coordinator I (Temporary) in Redwood City, California
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
Standing or sitting for long periods of time may be necessary
Some lifting (greater than 25 pounds) may be necessary; Facilities, Materials and Engineering employees occasionally must lift at least 50-75 pounds.
Requisition Number: 2017-5120
External Company Name: Genomic Health, Inc.
External Company URL: www.genomichealth.com
Travel, Physical/Mental Demands and Work Environment (Text Only): - Standing or sitting for long periods of time may be necessary - Some lifting (greater than 25 pounds) may be necessary; Facilities, Materials and Engineering employees occasionally must lift at least 50-75 pounds.