ABOUT US: At DermTech, we believe there's a better way to treat your skin, and we're using technology, innovation, and data to fundamentally change the way the world practices dermatology. We have developed technology that assesses your skin at the RNA and DNA level, so we can see signs of skin cancer far earlier, reduce the need for surgery, enable optimized treatment plans, and customize skincare plans to your skin's unique molecular makeup. We call this practice “precision dermatology” and we believe it truly is a new era in disease detection. A method that is not just better, but different. One centered around our patented smart sticker, which collects tissue from your skin's surface easily, accurately, and painlessly, and our state-of-the-art Gene Lab, which analyzes that tissue at the genomic level using a proprietary gene analysis system. By pushing the boundaries of areas like cancer detection and patient care, we truly believe our technology can change the world. And we're seeking team members with the vision, passion, and creativity to do the same.

FUNCTIONAL DESCRIPTION:

The successful candidate will excel at identifying, analyzing and resolving insurance company denials. While working with our Reimbursement, Commercial and Finance teams this role will provide on-going insight and analytics on all medical insurance claims.

  PRIMARY DUTIES AND RESPONSIBILITIES:

• Verifying insurance/recipient eligibility, billing and follow-up on claims to Medicare, Medicaid and Private Insurer Payers.
• Researching and responding to Medicare, Medicaid and other Payer inquiries regarding billing issues and insurance updates.
• Reviewing unpaid and/or denied claims, appeals and follow-up on accounts to zero status.
• Reviewing and interpreting explanation of benefits to determine contractual allowance.
• Researching accounts and resolving deficiencies.
• Calling insurance companies regarding outstanding accounts and utilizing payor websites to check claim status.
• Reviewing and submitting accurate claims, resubmissions and claim review forms.
• Researching and monitoring specific billing issues, trends and potential risks based on current research and customer feedback.
• Answering all patient/doctor/hospital/lab/insurance company phone calls regarding accounts, and taking appropriate action.
• When requested, providing administrative support for department(s) including but not limited to performing data entry, updating various record keeping systems, upholding company policies and Client requirements, and participating in projects, duties, and other administrative tasks.
• Communicates with patients to advise on status of insurance claims, as necessary.
• Contacts patients regarding collection of outstanding invoices.
• Fields inbound calls from patients regarding inquiries related to insurance claims.
• Makes outbound investigational calls to insurance providers to determine status of outstanding claims.
• Negotiates structured payment plans.
• Keeps up to date with specifications on all products and services.
• Confirms completion of required training plan before assuming job responsibilities.
• Ensures work is performed in compliance with company policies including Privacy/HIPAA and other regulatory, legal, and safety requirements.
• Additional duties as assigned by the management team.

EDUCATION/EXPERIENCE/SKILLS:

• 2-year degree from an Accredited Medical Billing School
• 2+ years of billing and claims follow up experience
• Experience with Xifin strongly preferred
• Experience with commercial payors
• Experience with molecular diagnostic billing preferred
• Familiarity with CMS 1500 claim form
• Strong customer service skills, including patient communications
• Experience in a HIPAA controlled environment is required.

SPECIFIC POSITION RELATED CERTIFICATIONS, LICENSES ETC:

TRAVEL: 0-24%

SCHEDULE: 

8am-4:30pm

REQUIREMENTS: Must complete initial training and successfully pass all assessments within 90 days of hire

Must be able to communicate effectively in English.  Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.  Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of organization. PHYSICAL DEMANDS AND WORK ENVIRONMENT CONDITIONS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. May be required to perform the following Physical Activity: Standing, walking, sitting, using hands, handle or feel, reach with hands and arms, climb or balance, stoop, kneel, crouch, or crawl, talk or hear, taste or smell.  May be required to lift 0 lbs. to over 100 lbs.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. May be exposed to the following environmental conditions: Wet or humid conditions, work near moving parts, work in high - precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, extreme heat (non-weather), extreme cold (non-weather), risk of electric shock, work with explosives, risk of radiation, vibration. The noise level in this work environment can range from quiet to very loud.

ADDITIONAL INFORMATION:

An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact Talent Acquisition. DermTech is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at DermTech via-email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of DermTech. No fee will be paid in the event the candidate is hired by DermTech as a result of the referral or through other means.