Clinical Reimbursement Assistant

This is a fully remote position, open to applicants in United States.

📋 Description

• Request and assess medical records to identify pertinent clinical information that supports genetic testing cases.

• Identify and flag any missing or incomplete documentation for necessary follow-up.

• Compile documentation packets for prior authorization, claims, or appeals submissions.

• Ensure precise case documentation is maintained within internal systems.

• Send and monitor medical record requests.

• Oversee case pipelines to guarantee that required documentation is obtained.

• Update internal systems with the status of records and outline next steps.

• Achieve daily and weekly task metrics for record requests and case progression.

• Assist in provider and patient outreach efforts concerning documentation or required forms.

• Monitor and document outreach efforts and their responses.

• Contribute to projects aimed at operational improvement and workflow efficiency.

• Collaborate with Genetic Counselors, Prior Authorization, Billing, and Appeals teams.

• Engage in team meetings and initiatives focused on process enhancement.

• Ensure accurate documentation while adhering to HIPAA/PHI compliance.

⛳️ Requirements

• High School Diploma or equivalent.

• Bachelor's degree in biology, genetics, life sciences, public health, or a related field, or equivalent years of relevant experience.

• Exceptional attention to detail coupled with strong organizational skills.

• Ability to read and interpret medical documentation effectively.

• Comfortable working in a data-centric, process-driven environment.

• Academic background in genetics or a healthcare-related discipline is preferred.

• Experience with medical records, healthcare documentation, or insurance workflows is preferred.

• Familiarity with Salesforce and Google Workspace is preferred.

• Strong written and verbal communication abilities.

• Capable of managing multiple cases and priorities concurrently.

• Willingness to learn new systems and workflows.

• Demonstrated initiative and eagerness to acquire new knowledge.

• Ability to work independently in a remote setting.

• Compliance with HIPAA/PHI standards.

🏝️ Benefits

• Comprehensive medical, dental, vision, life, and disability plans for eligible employees and their dependents.

• Complimentary testing for employees and their immediate families.

• Fertility care benefits.

• Leave for pregnancy and baby bonding.

• 401(k) benefits.

• Commuter benefits.

• Employee referral program.

• Fully remote work opportunities.

• Career advancement and hands-on learning opportunities.