Billing Coordinator Generalist
Sema4 is an interdisciplinary health information company that is helping patients, clinicians and researchers better predict health trajectories. We provide accurate & comprehensive genetic and genomic tests coupled with sophisticated information science to empower patients and their doctors to make better health decisions, now and in the future.
Formerly the Mount Sinai Genetic Testing Lab at the Icahn School of Medicine at Mount Sinai in NYC, Sema4 combines more than 160 years of clinical experience, world-class academic research that illuminates new directions, and the pioneering information science that puts all the pieces of data together to unlock answers to your health. Learn more at www.sema4genomics.com/ourstory.
The Billing Coordinator (Generalist) is responsible for multiple components of the billing process including, Data Entry, Insurance Eligibility, Accounts Receivable, Charge Entry, and Edits & Payment Posting. Proficient in these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution.
1. Verifies insurance and registration data for all lab samples received; reviews encounter
forms for accuracy.
2. Enters charges with accurate data entry of codes. Ensures charges are entered/processed in accordance with policies and procedures.
3. May work Telcor work queues denials list and process appeals.
4. May be responsible for obtaining pre-certification and pre-authorization for testing.
5. May post payments in Telcor using approved methodologies.
6. May perform specialty coding for services review physician coding and provide updates to physicians and staff.
7. Works daily Accounts Receivable accounts via online workfile and/or hard-copy reports; checks claims status, re-submits claims along with appeal letters as necessary.
8. Analyzes claims system reports to ensure underpayments are correctly identified and collected from key carriers. Identifies billing issues and provides recommendations.
9. Meets with Billing management / leadership on a scheduled basis to review Accounts Receivable and current billing concerns.
10. May assist in training new Billing staff.
11. Maintains working knowledge and currency in third party payor requirements.
Required: Associates Degree or high school diploma/GED
Preferred: 2 years of relevant experience
Training in computerized medical billing
- 2 years experience in medical billing systems or healthcare in an health insurance environment.
- Familiarity with ICD/CPT coding preferred
- Excellent organizational skills
- Excellent communication and customer service skills
- Knowledge of medical terminology
- Strong attention to detail and ability to multitask
- Excellent calculation, verbal and communication skills
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