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.