Reimbursement Specialist

The Reimbursement Specialist’s primary focus will be claim submissions and follow up. This role will work with various departments within CareDX such as Customer Care, Revenue Cycle and Patient Advocacy teams to ensure timely and accurate submission. This role is critical to maximizing potential revenue.

Responsibilities are as follows, but not necessarily limited to:

• Commercial or third party billing, client roster invoicing, claim processing, multi level appeals, collections, correspondence review and refunds

• Ensure proper reimbursement on patient accounts, identify and prepare adjustments and write-offs as appropriate

• Identify opportunities to streamline claim submission process in order to gain efficiencies

• Interpret contracts with payers to ensure proper payment, sending initial or secondary bills to insurance companies

• Compliant with internal processes which align with corporate business profit and budget objectives

• Notify CareDx Patient Advocacy team regarding center specific reimbursement issues

• Act as technical resource for internal and external CareDx customers and vendors

• Responsible for maintaining current knowledge of industry regulations and best practices

• Responsible for ensuring all financial procedures are followed and that any compliance issues are identified and addressed

• Work to meet department and corporate goals

• Compliant Corporate policies and procedures

• Minimum of four (4) years claim submission experience

• Bachelor’s degree preferred or equivalent years experience

• Strong knowledge of insurance procotols within Medicare, Medicaid, and Commercial payers.

• Highly focused, strong attention to detailed and organized while using multiple technologies and/or systems and managing emails efficiently

• Collaborative work ethic and ability to work in a team oriented culture

• Excellent communication skills, shares knowledge with excellent training skills

• Must demonstrate critical thinking and problem solving in prior work/school experiences

• 2-3 years' customer service experience in customer-centric organization/role

• Knowledge of Telcor systems a plus

Benefits & Perks: We provide Medical, Dental, Vision and Life Insurance, Flexible Spending and Dependent Care Accounts, Commuter Accounts, 401(k), 3 weeks of vacation, 5 days sick leave, 1 personal floating holiday, 9 paid holidays, gym reimbursement, yoga onsite, ping pong, foosball, BBQ’s, social hours, and more!