CareDx, Inc. is a leading precision medicine solutions company focused on the discovery, development, and commercialization of clinically differentiated, high-value healthcare solutions for transplant patients and caregivers. CareDx offers products, testing services, and digital healthcare solutions along the pre- and post-transplant patient journey, and is the leading provider of genomics-based information for transplant patients.
The Reimbursement Specialist handles remittance posting and is responsible for managing and processing payments received from insurance companies, patients or other healthcare providers for healthcare services provided to them. This role requires strong attention to detail and the ability to interpret payment information effectively.
Responsibilities:
- Accurately entering payments and adjustments into the billing system or electronic health records (EHR) based on remittance advice.
- Ensuring that payments are correctly applied to patient accounts and reconciling any discrepancies between billed amounts and received payments.
- Reviewing remittance advice to identify and address denied or underpaid claims. Translating letter format correspondence into standard remittance advice codes (example: ANSI Reason codes and Remark codes)
- Maintaining up-to-date records of payments, adjustments, and account statuses.
- Interacting with various internal teams, banks, healthcare providers, insurance companies, and patients to resolve payment-related issues and optimize revenue cycle processes
- Ensuring that all remittance posting activities adhere to regulatory standards and payer requirements. Adhere to HIPPA, PHI and confidentiality laws and guidelines.
- Identifying and addressing issues related to delayed payment application and finding alternative solutions when necessary. Develop strategies to mitigate these problems.
- Creating reports on payment activity, adjustments, and outstanding balances to assist in financial analysis and decision-making.
- Participates in staff and company meetings and events
- Recommends innovative approaches, suggestions in policies, and procedures to effect continual improvements in the efficiency of department
Qualifications:
- Requires a High School Diploma or equivalent.
- Proficiency in medical terminology, healthcare billing codes (CPT, HCPCS, ICD) and payer policies.
- Proficiency with healthcare management software (such as Telcor, XiFin, and QuadX), claims processing systems, Electronic Health Records (EHR), Electronic Medical Records (EMR) and insurance websites
- Efficiently manage remittance posting tasks, maintainaccurate financial records and support the overall revenue cycle process
- Understanding of regulatory compliance and insurance reimbursement processes is essential
- Previous experience in healthcare billing, coding, claims processing, particularly in diagnostic laboratory services, is highly valued
- Must have the ability to work independently with minimal supervision
- Capability to identify issues and develop effective solutions
- Must be able to maintain a professional and confidential working environment
- Must be able to analyze, summarize and provide details of findings when needed
- Strong written and verbal communication skills
Additional Details:
Every individual at CareDx has a direct impact on our collective mission to improve the lives of organ transplant patients worldwide. We believe in taking great care of our people, so they take even greater care of our patients. Our competitive Total Rewards package includes:
- Competitive base salary and incentive compensation
- Health and welfare benefits including a gym reimbursement program
- 401(k) savings plan match
- Employee Stock Purchase Plan
- Pre-tax commuter benefits
- And more!
In addition, we have a Living Donor Employee Recovery Policy that allows up to 30 days of paid leave annually to a full-time employee who makes the selfless act of donating an organ or bone marrow. With products that are making a difference in the lives of transplant patients today and a promising pipeline for the future, it is an exciting time to be part of the CareDx team. Join us in partnering with transplant patients to transform our future together. CareDx, Inc. is an Equal Opportunity Employer and participates in the E-Verify program.
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