Our mission at Progenity is simple: to help healthcare providers and patients prepare for life. We provide the most advanced molecular technology and the highest levels of service to guide patient care at critical life stages. We continually seek people with the motivation and skills to advance our mission.
The Director of Billing and Reimbursement Operations is responsible for overseeing collections for all insurance carriers and is responsible for the timely collection of all claims while meeting the performance standards and goals or the department.
RESPONSIBILITIES
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Leads and guides billing personnel in daily billing processes to ensure timely and positive cash flow.
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Works closely with Progenity’s 3rd party billing vendor to ensure accurate reporting and efficient collection of funds.
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Develops, implements, and maintains necessary policies, standards, and compliance procedures for the department.
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Monitors aging to ensure prompt resolution of escalated insurance carrier issues.
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Manages and coordinates the appeals process for federal, state, and third-party payer denials.
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Oversees the coordination of quality and completeness of clinical documentation supporting the appeals during the appeal process to ensure proper reimbursement is achieved.
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Ensures the department handles incoming calls from medical offices and patients.
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Provides accurate and detailed reporting to Senior Management regarding billing status.
This list of duties and responsibilities is not all inclusive and may be expanded to include other duties and responsibilities, as deemed necessary.
REQUIREMENTS
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Bachelor’s Degree in Business Healthcare or related field.
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Master’s Degree preferred.
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10+ years medical billing experience, including lab billing required.
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5+ years previous supervisory experience required.
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Knowledge of licensing, accrediting, CMS, and third party payer requirements.
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Proficient in working with Microsoft Office, specifically MS Excel.
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Strong oral and written communication skills.
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Must be able to handle a wide work variety in a fast-paced environment.
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Must be detail-oriented, organized, self-starting, and have an ability to prioritize workload.
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Ability to analyze and interpret data and solve practical problems.