Requires knowledge of the billing and laboratory testing operations. Obtains and manages any required documentation as required by state or other regulatory entities for designated testing. Required to determine preauthorization, informed consent requirements and other documentation needs from a variety of insurance plans, payers and other governing sources. Handles all payer, physician and patient contact received by telephone and in writing. Troubleshoots both complex medical/technical compliance and routine requests. Deals with the coordination and review of laboratory testing and billing processes. Collaborates with other third party partners as needed.
- Handles all client inquiries regarding preauthorization, informed consent requirements and other documentation needs from a variety of insurance plans, payers and other governing sources.
- Coordinates testing in parallel to obtaining proper documentation to comply with all payer requirements.
- Documents reporting or call history in the patient file and maintains appropriate records.
- Uses established protocols for reporting client concerns.
- May provide technical training to new hires and coach less experienced staff.
- Recognizes quality service issues and provide feedback to appropriate personnel on opportunities for improvement.
- May assist Manager in the delegation of work.
- Has ongoing responsibility for maximizing department quality and productivity by monitoring service levels and minimizing abandoned calls.
- Other duties as required.
- BS degree required. In lieu of degree, 10yrs+ technical or customer service experience required.
- Medical Billing experience preferred.
- Strong understanding of medical terminology required.
- Must have strong communication skills.
- Proficiency with Microsoft Office products required (Excel, Word, PowerPoint, etc.)
- Ability to handle complex processes and have demonstrated experience utilizing strong independent problem solving skills.
- Willingness to accept additional responsibilities with a positive attitude that fosters collaboration and teamwork.
- Must exhibit comfortable interaction with technical staff including laboratory managers, Medical leaders, and other technical personnel.
- Ability to handle patient specimens, as required.
- Strong commitment to integrity, compliance, and adherence to company values.
All requirements are subject to possible modifications to reasonably accommodate individuals with disabilities. Quest Diagnostics is an Equal Opportunity Employer: Women / Minorities / Veterans / Disabled / Sexual Orientation /Gender Identity.