Billing Service Specialist (Remote - Denver, CO Area)

Job Description

Billing Service Specialist | Monday - Friday 

Remote position, but must sit in Denver, CO area - 25% local travel due to client visits

Pay Range: $58,656 - $102,100 / year
Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and, where applicable, certifications obtained. Market and organizational factors are also considered. Successful candidates may be eligible to receive annual performance bonus compensation.

Benefits Information:
We are proud to offer best-in-class benefits and programs to support employees and their families in living healthy, happy lives. Our pay and benefit plans have been designed to promote employee health in all respects – physical, financial, and developmental. Depending on whether it is a part-time or full-time position, some of the benefits offered may include:

•    Day 1 Medical, supplemental health, dental & vision for FT employees who work 30+ hours 
•    Best-in-class well-being programs
•    Annual, no-cost health assessment program Blueprint for Wellness®
•    healthyMINDS mental health program
•    Vacation and Health/Flex Time
•    6 Holidays plus 1 "MyDay" off
•    FinFit financial coaching and services
•    401(k) pre-tax and/or Roth IRA with company match up to 5% after 12 months of service
•    Employee stock purchase plan
•    Life and disability insurance, plus buy-up option
•    Flexible Spending Accounts
•    Annual incentive plans
•    Matching gifts program
•    Education assistance through MyQuest for Education
•    Career advancement opportunities
•    and so much more!

Manage and educate accounts that are considered billing top-offenders with Missing Information and valid - ABN rates. Recover account Missing Information for records in BIP >30 days old. 

Responsibilities:

• Monthly client visits will be conducted as part of the job responsibilities.  
• Accounts visits will be prioritized based on Missing Information/ABN status and geographic location 
• Billing Service Representative will be responsible for communicating results of client education process on Missing Information and ABN improvements to the BU management teams.  
• Coordinate with BU Sales Department any collaborative client visits that may be required.  
• Provide training to new BU Sales Representatives during NEOP process.  
• Manage and educate lab Operation and PSCs top-offenders on edit requirements for billing.  

Qualifications:

Required Work Experience:  

• 2 - 4 years related experience 

Preferred Experience

• Previous Quest Diagnostics Billing experience 
• Understanding for BIP(missing information required to bill like diagnosis code, physician enrollment, insurance info, group id)
• Understanding of PPC write offs (patient price concessions write offs because of lack of supportive diagnosis codes provided by providers, insurance denials, clients not able to send accurate insurance information or slides or discounts, client EMR issues, etc.)

Required Education:  

• High School Diploma or Equivalent  

Skills:  

• Ability to develop and sustain good customer relations. 

• Strong planning and organization skills. 

• Ability to work independently. 

• Problem solving skills to identify issues from data, solution mindset and autonomy to reach out & collaborate with all teams as needed to produce mitigation 

• Excellent written and communication skills. 

• Ability to work cross functionally with commercial, billing teams, health plan teams, customer solutions, etc. 

• Customer First and Customer service approach to interactions with physicians & providers

• Data analysis skills to track billing data, patient AR, BIP codes, denial trends, reimbursement patterns, write off reasons to be able to understand them and provide recommendations and train clients to increase profitability and reduce write offs from BIP/AR

• Ability to identify billing process gaps that are causing at risk and recommend workflow improvements by working closely with billing function

• Skilled in developing and delivering training sessions to providers, physicians, clinical staff on correct documentation, ICD 10 coding for tests and payer combinations and coverage requirements to proactively avoid denials and write offs during client onboarding. Example topics but not limited to – Trailers,  enrollments, missing information required to bill, limited coverage policies, UPP, slides, etc. ) 

• Effective at communicating complex payer rules in clear and actionable terms

• Ability to create reference materials, quick guides, for internal and external stakeholders 

Knowledge:  

• Knowledge of in lab diagnostics billing, including CPT, ICD-10 coding specific to laboratory tests and clinic services, CMS guidelines, HIPAA 

• Understanding of commercial third party, Medicare, Medicaid, Payer claim submission requirements, medically limited coverage policies to prevent third party denials, reasons causing higher patient bills

• Ability to analyze claim denials, patient and client billing statements, identify root cause and recommend corrective actions 

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Quest Diagnostics honors our service members and encourages veterans to apply.

While we appreciate and value our staffing partners, we do not accept unsolicited resumes from agencies. Quest will not be responsible for paying agency fees for any individual as to whom an agency has sent an unsolicited resume.

Equal Opportunity Employer: Race/Color/Sex/Sexual Orientation/Gender Identity/Religion/National Origin/Disability/Vets or any other legally protected status.