Genomics Reimbursement Analyst Team Lead

Job Description

Under the direction of the Genomics Revenue Cycle Manager, the Genomics Reimbursement Analyst Team Lead serves as a working team lead for a team of Accounts Receivable specialists to ensure timely and effective processing and collection of payments.

This individual will be responsible for participating in all AR activities, including but not limited to billing/charge entry, payment posting, accounts receivables analysis, and customer service functions.  In a team leadership capacity, activities include but are not limited to coordination of accounts receivable workflows and daily work assignments, training of new staff, and establishment of policies and procedures.

About CooperSurgical

CooperSurgical is a leading fertility and women's healthcare company dedicated to putting time on the side of women, babies, and families at the healthcare moments that matter most in life. CooperSurgical is at the forefront of delivering innovative assisted reproductive technology and genomic solutions that enhance the work of ART professionals to the benefit of families. We currently offer over 600 clinically relevant medical devices to women's healthcare providers, including testing and treatment options.

Responsibilities

• Front-end Billing
  • Accurately bill charges for completed lab tests based on test requisition form and laboratory final report.
• Payment Posting
  • Post payments, denials, and correspondence from all sources (ERA, lockbox, mail, credit card processing vendor, collection agency) in the billing system.
  • Confirm and reconcile all payments to banking source on a daily basis.
• Accounts Receivables Analysis
  • Follow-up on denials and no response insurance claims
  • Daily monitoring and resolution of “EP Denial” errors in an accurate, efficient, compliant manner to ensure “clean claim” submission and reduce days in AR
  • Research eligibility rejections including contacting of patient to determine current insurance coverage
  • Communicate finding of payer trends to Manager
    1. Weekly analysis of “aged trial balance” report
  • Research refund requests from patients and insurance; prepare and document refunds for referral to AP.
• Collections for Client and Patient Billing 
  • Support the processes for past-due collections.  May include:
    1. Pre-collection “soft calls” to patients
    2. Compilation of accessions which have completed the dunning cycle for referral to outside collections.
       1. Coordination with outside collection agency on reconciliation of accounts
    3. Follow-up on outstanding “Client-Bill” AR
• Customer Service
  • Assist customer service representatives with resolution of patient billing questions received both electronically via telephone
• Leadership of Team
  • Daily monitoring and coordination of work assignments for AR team
  • Assisting team members with escalated patient concerns
  • Training of new staff
  • Liaise with other team leads/managers departments on resolution of interdepartmental challenges
  • Reporting and collaboration with manager on:
    1. Resolution of “big picture” trends and issues
    2. Establishment of policies and Standard Operating Procedures (SOP)
    3. Analysis of AR key performance indicators (KPI)

Qualifications

• 5 years’ experience effectively working with and leading a team
• Credit and collection experience
• Healthcare revenue cycle operations experience
• Customer service experience preferred
• Knowledge of medical billing conventions including (but not limited to) CPT, ICD-10, explanation of benefits, CMS-1500 form and client-style billing.
• Thorough comprehension of the differences between in-network insurance claims and out-of-network insurance claims
• Complex understanding of insurance payor requirements, guidelines, and appeals processes
• Extensive knowledge of patient out-of-pocket expenses including co-pays, deductibles and co-insurances.
• Computer competencies to include solid grasp of MS Word and above-average skill with MS Excel.
• Excellent written and verbal communications skills including the ability to effectively communicate with managers, executives, peers in other departments, patients, IVF clinics and sales personnel Ability to think critically and problem-solve with an eye toward root-cause analysis
• Ability to clearly, concisely and respectfully delegate tasks and communicate feedback to team members
• Willingness to work collaboratively and build relationships within the department/organization and externally
• Reliability, good organization skills, and able to take direction.
• Must be able to maintain confidentiality of data including HIPAA, SOX and other similar regulations.
• Consistently meet deadlines in a fast-paced, changing, and high-tech environment.
• Passing of background check, which may include verification of prior employment, criminal conviction history, educational, and driving records.

Confidentiality:

• This job requires use and analysis of this type of information:
• Patient billing, financial status, insurance coverage.
• Corporate financial, marketing, or business strategies

Teamwork and Collaboration:

• This job serves as a member of a formal team across departments. This job is involved in decision making and work design that affects more than one department area.