Note: The job is a remote job and is open to candidates in USA. Adaptive Biotechnologies is focused on transforming the way diseases are diagnosed and treated through the power of the adaptive immune system. The Reimbursement Account Specialist I supports patients and providers throughout the reimbursement lifecycle, managing inquiries and coordinating documentation to ensure a positive experience for all stakeholders.
Responsibilities
- Manage inbound calls from patients, provider accounts, and payers regarding reimbursement issues, billing status, prior authorizations, and Adaptive Assist enrollment
- Identify the nature of each inquiry and triage calls to the appropriate teams when needed
- Provide clear, accurate, and empathetic support to all callers
- Contact provider offices to obtain outstanding documentation required to move reimbursement requests forward
- Communicate required materials, confirm provider understanding, and document commitments to submit missing information
- Maintain accurate, timely documentation to support reimbursement workflows and audit readiness
- Assess all self-pay patients and patients with outstanding balances for eligibility into Adaptive
- Assist Patient Support Program’s financial assistance and enroll qualifying patients
- Document assistance qualifications into the internal and billing vendor patient records
- Audit the PFAP on a regular basis to compliance with all current guidelines
- Collaborate with internal partners to run needed orders through external vendor platforms to check for insurance eligibility and/or financial assistance qualification
- Review patient bills for appropriateness and release when necessary
- Collect pre-payment from appropriate self-pay patients
- Work with customers and embassies to collect payment for international patients
- Contact patients for Advanced Beneficiary Notices when needed
- Evaluate held orders for proper ICD codes, needed documentation and other requirements
- Update orders and resolve holds when appropriate
- All other duties as assigned
Skills
- Bachelors degree in related field or equivalent experience
- Familiarity with basic laboratory and customer service-related systems such as LIMS and SFDC, or similar systems
- Proven track record of improving processes and solving problems
- Demonstrated ability to work effectively with physician office clients and with patients on billing-related matters
- Excellent written communication skills are required, including technical computer proficiency (Word, Excel, etc.)
- Strong ability to work independently, think critically and problem solve
- Ability to work effectively across multiple functions within the organization and customer's offices
- Strong interpersonal skills and experience navigating organizational dynamics
- Use of empathetic listening skills in communication with customers
- Flexible, team-player with ability to develop best practices for procedures on new assignments
- Strong attention to detail and meticulous data entry skills
- Ability to manage multiple tasks to completion in a dynamic office setting
- 1-2 years in customer service, medical billing, and revenue cycle operations
- Direct knowledge of ICD-10 codes, CPT codes, and general billing practices in the laboratory services space
- Knowledge and familiarity with patient assistance programs
Benefits
- Equity grant
- Bonus eligible
Company Overview
- Adaptive Biotechnologies is a pioneer and leader in immune-driven medicine that aims to improve people’s lives by learning from the wisdom of their adaptive immune systems. It was founded in 2009, and is headquartered in Seattle, Washington, USA, with a workforce of 501-1000 employees. Its website is http://adaptivebiotech.com.