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Reimbursement Specialist
Veracyte, Inc.. Participate in day-to-day operations of the insurance billing life cycle .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing and insurance claims processing, with a strong focus on accuracy, compliance, and timely submissions. Proficient in navigating payer portals and utilizing analytical skills to resolve billing issues and enhance patient financial experiences.
Highest-signal resume keywords
Medical Billing ExperienceInsurance Claims ProcessingPayer Portal NavigationHIPAA Compliance FamiliarityMicrosoft Excel Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical BillingInsurance ClaimsAccounts ReceivableICD CodingHCPCS/CPT CodingClaim Tracking SystemsData EntryFinancial AnalysisClaim Adjustment Reason CodesCMS 1500 Claim Form
Soft Skills
Attention to DetailOrganizational SkillsCommunication SkillsInterpersonal SkillsTime Management
Tools & Technologies
Microsoft OfficeSalesforceEpicXiFinQuadax
Industry Keywords
Healthcare AdministrationRevenue Cycle OperationsInsurance Coverage VerificationPatient Financial AssistanceBilling Compliance
About the role
Key responsibilities & impact- Participate in day-to-day operations of the insurance billing life cycle
- Verify patient insurance coverage and benefits
- Ensure timely and accurate insurance claim submissions
- Post payments
- Perform accounts receivable follow-up
- Send appeals
- Research and monitor billing issues, trends, and potential risks
- Review claims for accuracy and pre-claim requirements
- Track claim status and pull reports, especially in Excel
- Review denied or unpaid claims and take corrective action, including resubmission and appeals
- Provide administrative support, including data entry, record keeping, policy and client requirement compliance, projects, and other administrative tasks
- Navigate payer portals, websites, and phone systems to check eligibility, prior authorization, claim, and appeal statuses
- Apply payer guidelines and policies to daily decision-making
- Assist patients with their financial journey
- Verify benefits with Medicare, Medicaid, and private insurers
- Complete billing responsibilities accurately and on time each day
- Review and interpret explanations of benefits
- Work with insurance companies, internal teams, customers, and patients with compassion and clarity
Requirements
What you’ll need- High school diploma or GED
- Associate's or bachelor's degree in healthcare administration, business, or related field preferred
- Use of personal computer, computer applications, and general office equipment
- Experience with Microsoft Office, especially Word and Excel
- 2+ years of experience in medical billing, insurance claims, or revenue cycle operations
- Experience with payer portals and claim tracking systems
- Familiarity with HIPAA compliance and healthcare privacy regulations
- Experience working with CRMs such as Salesforce and billing software such as Epic, XiFin, or Quadax
- Strong, consistent work ethic with attention to detail and ability to focus on the big picture
- Ability to use analytical, interpersonal, communication, organizational, numerical, and time management skills
- Good organization skills with ability to meet deadlines and manage several projects at a time
- Enthusiasm and an entrepreneurial spirit
- Familiarity with ICD and HCPCS/CPT coding preferred
- Familiarity with CMS 1500 claim form preferred
- Familiarity with Claim Adjustment Reason Codes (NUCC) preferred
Benefits
Comp & perks- Competitive compensation and benefits
- Potential eligibility for discretionary bonuses/incentives
- Potential eligibility for restricted stock units
- Career opportunities and growth within a purpose-driven environment
- Inclusive workforce and workplace
- 2024 Certified Great Place to Work recognition in the US and Israel