PFS Insurance Specialist I

Ambry Genetics

Posted 3 months ago

Full Time

, Utah

Remote OK

Smart Summary

Responsibilities

Assist the collections team in increasing cash collections and improving reimbursement rates by managing outstanding A/R and denials. Responsible for reviewing EOBs, sending corrected claims, and providing coaching to team members to meet productivity standards.

Qualifications

You have 1-2 years of experience working with denials and a strong understanding of medical terminology, insurance plans, and CPT/ICD 10 codes. You are proficient in MS Excel and possess excellent computer skills, with knowledge of different payer plans and basic A/R understanding.

Must Have Skills for ATS

CPT codes

medical terminology

insurance plans

ICD 10 codes

Xifin

MS Excel

Job Description

Compensation:

$27.00 - 28.00 per hour

Job Overview:

The PFS Insurance Specialist’s main role is to assist the collections team towards department goals of increasing cash collections and improving reimbursement rates. The PFS Specialist should have the ability to work on any claim, regardless of aging, and must work with both commercial and government payers, and review EOB’s.

Job Responsibilities:

  • Works with collections team to ensure daily productivity and quality standards are met, as well as assist with training and coaching to ensure all team members are operating at full potential
  • Creates notes on the patients account for auditing and actions taken per the Standard Operating Procedures or as outlined by the team manager
  • Works the total patient accounts outstanding A/R including credits and denials to reduce A/R aging buckets per the department’s goals
  • Works hand in hand with the other team members to correct errors
  • Send corrected claims and appeals based on payer guidelines in a timely manner
  • Other projects as assigned

Education and Knowledge:

  • High school diploma plus some college preferred
  • Knowledge of CPT codes, medical terminology, insurance plans, ICD 10 codes
  • Must have ability to adapt to a fast paced, dynamic environment
  • Must understand different payer plans collections process, Xifin knowledge preferred

Technical Competencies:

  • Must have excellent computer skills
  • Must understand the different payer plans and basic understanding of A/R
  • Must have working knowledge of MS Excel

Experience:

  • 1-2 years’ experience in a clinical laboratory preferred, especially genetic billing
  • 1-2 years’ experience in working denials

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Equal Opportunity Employer


This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Ambry Genetics

Ambry Genetics, a Tempus company, translates scientific research into clinically actionable test results based upon a deep understanding of the human genome and the biology behind genetic disease. It is a leader in genetic testing that aims to improve health by understanding the relationship between genetics and disease. Its unparalleled track record of discoveries over 25 years, and growing database that continues to expand in collaboration with academic, corporate, and pharmaceutical partners, means Ambry Genetics is first to market with innovative products and comprehensive analysis that enable clinicians to confidently inform patient health decisions. Hiring Fraud Alert: Ambry has received reports of employment scams in recent months that seek financial commitments, or requests personal information from job candidates. Unsuspecting job seekers have reported receiving unsolicited contacts by phone, email or text from individual(s) posing to be or represent Ambry recruiter(s). If you’ve experienced either of these scenarios, please visit this page to learn more about hiring fraud: https://consumer.ftc.gov/articles/job-scams. Or visit https://www.ambrygen.com/company/careers/recruitment-fraud-alert to learn more about our policy on recruitment fraud. You can confirm the legitimacy of a job posting by viewing our current open roles at https://ambrygen.com/careers.
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