Billing Support Specialist II - Remote Eligible

Billing Support Specialist II

We operate with conviction that what is best for our customers (patients, their families and the clinicians, payers and partners who serve them) must be embedded in every aspect of our work.

At GeneDx we believe:

• Genomic information has broad utility, and every person should have access to their genome delivered expertly, ethically, and responsibly -- to guide health decisions throughout life.
• The transition from hypothesis-based to genome-guided healthcare will improve outcomes for patients and the healthcare system that benefit society as a whole.
• Genomics will radically transform therapeutic development, bringing better therapies to patients, faster; and patients should control and can direct the use of their genomic information to benefit both themselves and advance scientific understanding that helps others.

In support of these beliefs, we value:

• Openness, Accountability, Simplicity, Curiosity, Rigor, Efficiency, Equitability, Integrity, Humility, and Bravery.

Through this value system we aim to revolutionize healthcare and change lives by unlocking the answers from within, bringing better health from genomics to patients around the world.

Job Responsibilities:

• Provide exceptional customer service to patients and healthcare providers, addressing inquiries and concerns promptly and professionally via phone and email
• Participate in a dynamic rotational schedule, alternating weekly between one week managing inbound calls and one week addressing emails, tickets, outbound calls, and "problems".
• Exhibit agility and flexibility to adapt swiftly to changes in the rotational schedule, ensuring seamless transitions to meet evolving business demands.
• Enter and maintain accurate patient information in systems, ensuring data integrity.
• Review and manage various forms, including medical hold forms and faxes, while handling inbound and outbound queues.
• Investigate and resolve billing discrepancies and disputes efficiently, processing payments, refunds, and adjustments accurately.
• Maintain detailed and accurate records of customer interactions and transactions.
• Collaborate with finance and customer service teams to ensure seamless billing operations and provide customers with information about billing policies procedures, and payment options.
• Identify opportunities for process improvements and contribute to the enhancement of billing procedures.
• Utilize medical terminology for clear communication with patients and healthcare professionals.
• Analyze and resolve customer concerns effectively by utilizing appropriate resources.
• Address billing inquiries, including benefit investigation and prior authorization questions, from clients and patients.
• Contact clients and insurance companies to obtain necessary information for prior authorization and claim submission.
• Provide client education regarding general billing-related issues as needed.
• Navigate various payor types, including Accountable Care Organizations (ACOs), Cash Pay, Commercial/Private Payors (Regional, National Plans), Medicare (Part A and B Carriers), and Medicaid (Fee for Service, Managed Care organizations).

People Manager:

• No

Education, Experience, and Skills:

• High school diploma or equivalent; associate or bachelor's degree in a related field preferred.
• Knowledge of medical terminology to effectively communicate with patients and healthcare providers
• Strong data entry skills with a high level of accuracy and attention to detail
• Working knowledge of 3rd party payor policies, including prior authorizations and medical benefits
• Excellent phone etiquette and interpersonal skills to provide outstanding customer service
• Ability to communicate clearly and effectively
• Passionate about providing excellent customer service in the healthcare industry
• Must be able to multi-task in a fast-paced environment
• Ability to handle stressful or difficult situations with the ability to deescalate calmly and professionally
• Comfortable interacting with technical staff and other departments
• Driven and focus minded to work within a remote setting
• Proven experience in a billing or customer support role, preferably in a healthcare or laboratory setting.
• Strong understanding of billing processes and procedures.
• Excellent verbal and written communication skills.
• Proficiency in using billing software (Xifin and Careviso is a plus)
• Proficiency in Salesforce.
• Proficiency in Microsoft Office
• Strong problem-solving skills and attention to detail.
• Ability to work independently and as part of a team.
• High level of empathy and customer service orientation.
• Attention to detail and accuracy

Preferred:

• 1-3 years clinical laboratory, physician's office, and/or healthcare, insurance and/or billing customer service experience
• Proven experience in a billing support role, preferably in a laboratory setting.
• Bilingual speaking

Certificates, Licenses, Registrations:

• None

Physical Demands:

• 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.
• While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds.

Work Environment:

• Work is primarily performed in remote office setting.
• Must be available Monday - Friday between 8:00am-8:00pm, EST for an 8-hour shift.

Acknowledgements:

The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.

#LI-REMOTE

Pay Transparency, Budgeted Range:

$25 - $31 USD