Reimbursement Specialist
Natera - San Carlos, CA
Reimbursement Specialist

JOB SUMMARY:
Will validate the correct billing of accounts, Will identify accounts for approval for transfer to external collection agency and will identify accounts to be kept for internal follow up with patients. Will promote a patient friendly focus to present opportunities for settlement of accounts by the patient through respectful contact and education of patients regarding personal financial responsibilities. Will comply with State and Federal policies and regulations including the Fair Debt Collection Act concerning collection activities. Adheres to policies, procedures and regulations to ensure compliance and patient safety.
ESSENTIAL FUNCTIONS:
  • Perform accounts receivable / bad debt follow up activities, quality assurance audits for assigned payers (patients) using aged account work queues and accounts receivable reports and review of accounts at invoice level.
  • Analyze accounts, reconcile and apply changes to patient invoices and accounts to correct account issues; initiate inquiries, either by telephone or in writing, to third party payors to resolve reimbursement issues.
  • Follow up directly with patients either by telephone or in writing to resolve outstanding accounts receivable issues. Responsible for providing patient with information that will be helpful in explaining financial responsibilities, and providing opportunities to make payments toward account.
  • Proactively identify patients unable to pay accounts in full. Partner with patients who are unable to pay balance in full to develop and implement a payment plan, and monitor for compliance.
  • Audit patient accounts for accuracy of insurance posting, proper secondary billing and authentic credit balances which may require a refund to the patient.
  • Respond to requests from third party payors and / or patients regarding reimbursement problems and issues.
  • Respond by telephone or in writing to inquiries from patients explaining insurance coverage, research problems, and correct errors.
  • Maintain tracking system of accounts worked and outcome of each contact. Initiate any follow up issues with appropriate parties and maintain tracking of all communications. Work with clinical units to communicate anticipated opportunities for cash collections.
  • Work closely with business partners to ensure billing issues are addressed in timely, comprehensive and pro-active manner. Be responsible for identifying and documenting payer issues as they arise and communicate effectively with business partners.
QUALIFICATIONS:
Required - High School Diploma or GED.
Preferred - Associates Degree in business
administration or related field
Required – Three (3) of credit and collections experience; in Healthcare.
Preferred - experience in patient collections in a Medical practice setting.
KNOWLEDGE/SKILLS/ABILITIES
Knowledge of medical billing experience, familiarity with medical claims, explanation of benefits, coordination of benefits, medical claim denial information, and any other medical claim correspondence. Ability to identify and resolve reimbursement related to all medical insurance payor groups. Ability to communicate effectively, both orally and in writing. Excellent analytical skills, ability to read medical billing transactions at invoice level. Advanced computer skills, ability to gather, compile and analyze data. Research, analytical, and critical thinking skills. Ability to use independent judgment and to manage and impart confidential information. Strong customer service focus for both internal and external customers.
Natera is a genetic testing company that has developed a proprietary bioinformatics-based technology (NATUS) to deliver accurate and comprehensive high-throughput testing for reproductive indications from tiny quantities of DNA. Natera operates a CLIA-certified laboratory in San Carlos, Calif., providing a host of preconception and prenatal genetic testing services.
Equal Opportunity
Natera affords equal employment opportunities to all qualified persons, regardless of race, color, religion, national origin, age, sex, disability, sexual orientation, gender expression, veteran or marital status.
Natera participates in

E-Verify in the United States.

Natera - 28 days ago - save job - block
Recommended Jobs
Intellectual Property Technology Specialist
WilmerHale - Palo Alto, CA
WilmerHale - 1 day ago

Fellowship Program Specialist
University of California San Francisco - San Francisco, CA
University of California San Francisco - 4 days ago

US PAYROLL SPECIALIST
Centrify Corporation - Santa Clara, CA
Centrify Corporation - 8 days ago
About this company
12 reviews
Natera is driven by a passion for elevating the science and utility of prenatal testing. The advent of the Information Age has created a...