- emphasis on speaking with potential patients or providers regarding patient expected out of pocket costs including both inbound and outbound calls
- patient billing questions and resolve accordingly
- entry of patient insurance plan and demographics into Salesforce
- worklists assigned by our billing vendor and resolve any questions to ensure timely filing of our claims
- the prior-authorization process for our claims when applicable
- calls to providers for additional documentation to ensure successful claim submission/adjudication
- and communicate necessary changes to improve departmental efficiencies
- keen disposition when speaking with patients regarding their out-of-pocket costs.
- billing system and Salesforce experience highly preferred
- with insurance verification and prior-authorization process
- understanding of commercial and government payer behavior
- be able to comprehend and communicate EOB details
- of appeal processes
- portal data entry experience
- communication skills
- Office 365 proficiency
- on Zoom/Microsoft Teams for daily meetings
- time management and prioritization abilities
- be able to work in a fast-paced environment and provide solutions to processes not yet defined
- confidentiality; adheres to all HIPAA guidelines and regulations
- years of insurance billing experience preferably within a laboratory environment
- service, data entry, insurance verification, understanding the life of a claim, appeals and prior-authorization experience
- degree and/or Medical Billing Certification preferred. May be substituted DOE
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Billing Support Specialist - Salt Lake City, United States - Scipher Medicine
Description
Scipher Medicine is seeking a qualified and dedicated Billing Support Specialist to join our Billing team.This full-time position reporting directly to the Billing Manager is based out of the Salt Lake City office. As a key member of the team, you will be responsible for a variety of tasks including providing customer service and support to our patients for all billing inquiries. To succeed in this role, you must possess strong communication skills, both orally and written, a thorough understanding of billing systems, claims processing, insurance plans and appeal processes.
Essential responsibilities include the following but are not limited to and other duties may be assigned:
Front-End billing functions such as:
Required skills:
Basic qualifications:
About Scipher Medicine
Scipher Medicine develops innovative diagnostic tests to determine drug response and targeted therapies using our proprietary personalized medicine platform based on molecular technology. We hold a fundamental belief that patients deserve simple answers to their treatment plans using scientifically backed data. Our platform allows us to interpret genomic data to gain unique insights into disease biology so patients with even the most complex diseases can achieve optimal health outcomes.
With only about 1 out of 3 rheumatoid arthritis (RA) patients adequately responding to anti-tumor necrosis (anti-TNF) therapies, the world's largest selling drug class, we developed our flagship test, PrismRATM, to predict response to these drugs, thereby ensuring patients receive more effective therapies from day one. Scipher is transforming the traditional diagnostics business model by working closely with payers and physicians to change the way medications will be prescribed, substantially improving patient outcomes while saving both insurers and patients billions wasted in ineffective prescription costs. This is a unique opportunity to join a promising venture at an early stage to tackle some of the biggest problems in healthcare.
Scipher is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law