Job Description

Eurofins Transplant Genomics Inc. (“ETG”) is a molecular diagnostics company committed to improving organ transplant outcomes with non-invasive serial monitoring guided by biomarkers. ETG’s product portfolio of both individual and combined whole blood gene expression and donor derived cell-free DNA testing is capable of reliably ruling out subclinical kidney rejection and acute rejection in kidney transplant patients. In addition to kidney transplantation testing, our newest product for liver transplant patients is a blood-based biomarker assay designed to rule out rejection as immunosuppression therapy is optimized.

Basic Function and Scope of Responsibility:

The Billing Specialist effectively communicates the estimated financial responsibility of the member and obtains prior authorization for billing. To achieve this, the Specialist is responsible for verifying the receipt of test order IDs, checking the member's insurance and benefits, communicating the member's financial responsibilities to the patient and/or sales team, submitting prior authorization requests through payor websites, fax or phone, and procuring medical records or documentation as required by insurance prior authorization or appeals. They must also keep up to date with changes in insurance policies and pre-certification requirements and maintain current knowledge of payor websites and utilization. Reviewing claims in Xifin and resubmitting them to payors for Pre-authorization reviews is also part of their job. They are responsible for ensuring that pre-certification, authorization, and referrals are in place for all cases. Entering payor and responsible party information accurately into the accounting system is crucial. The Specialist must also possess exceptional task prioritization skills and the ability to review tasks efficiently and thoroughly. In case of necessity, the Specialist should cross-train in various duties within the Billing department. Research is also a crucial aspect of this role, and the Specialist must follow up and know how to appeal prior authorization rejections/denials. This role also includes monitoring FAP's.

Qualifications

• A minimum of 2 years' experience in billing with knowledge of EOBs (Explanation of Benefits), deductibles, and co-pays is required.
• A minimum of 3 years Xifin experience.
• A minimum of 2 years' client and operational experience in diagnostics is preferred.
• Excellent customer service skills, with a focus on professionalism
• Ability to solve problems, prioritize tasks, and multitask effectively
• Goal-oriented mindset with excellent time management and organizational skills
• Strong interpersonal communication skills, including the ability to interact efficiently with individuals at all levels in an organization
• Strong level of empathy & patience
• Excellent verbal and written communication skills
• Attention to detail, accuracy, and time management
• Proficiency in PC-based software such as Microsoft Excel, Teams, iPhone, Adobe, and associated applications
• A fundamental understanding of medical billing concepts
• Knowledge of Medicare, Medicaid, and commercial insurance
• Familiarity with HIPAA (Health Insurance Portability and Accountability) privacy requirements
• Knowledge of Availity and eligibility portals and medical terminology
• Follow up on missing or incorrect information so patients receive the right reimbursement.
• Document account activity using correct medical and billing codes.
• Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
• Be investigative to find necessary information, if needed
• Ability to handle multiple priorities and meet deadlines
• Ability to work independently and as part of a team in a fast-paced environment
• Demonstration of self-motivation and ownership of assigned work
• A high level of professionalism and confidentiality in handling sensitive information is imperative.
• Ability to self-start and work independently as well as respond to STAT requests in a timely manner

Additional Information

To learn more about Eurofins Transplant Genomics, please visit the following: transplantgenomics.com.

Schedule:

• Monday - Friday, 8 am - 5 pm

What we offer:

• Excellent full time benefits including comprehensive medical coverage, dental, and vision options
• Life and disability insurance
• 401(k) with company match
• Paid vacation and holidays

Eurofins USA Clinical Diagnostics is a Disabled and Veteran Equal Employment Opportunity employer.