Reimbursement Specialist Customer Support

About Us

Would you like to be part of a fast-growing team that believes no one should have to succumb to viral-mediated cancers Naveris a commercial stage precision oncology diagnostics company with facilities in Boston MA and Durham NC is looking for a Reimbursement Specialist Customer Support team member to help us advance our mission of developing and delivering novel diagnostics that transform cancer detection and improve patient outcomes. Our flagship test NavDx is a breakthrough blood-based DNA test for HPV cancers clinically proven and already trusted by thousands of physicians and institutions across the U.S.

Opportunity

We are looking for a conscientious knowledgeable individual to join our team and support the varied aspects of the reimbursement process. While Naveris partners with an outsourced RCM vendor this role will provide additional oversight and direct involvement including reviewing claim submissions supporting appeals and communicating with payers providers and patients across Medicare Medicaid and commercial insurance plans.

Job Responsibilities

Reporting to the Reimbursement Supervisor Front End this role supports the Reimbursement department with a focus on front-end reimbursement activities and patient-facing billing support. This position is remote. Responsibilities include:

• Handle inbound and outbound calls faxes and emails determining appropriate next steps and resolutions
• Communicate clearly and empathetically with patients and providers regarding billing policies EOBs financial assistance programs and member responsibility
• Explain insurance-related processes to patients and address non-clinical billing questions
• Critically assess complex or sensitive situations and escalate to leadership when appropriate
• Understand and communicate the reimbursement process from intake through resolution
• Deliver a high level of customer service while managing multiple concurrent priorities
• Utilize internal systems tools and vendor resources to support reimbursement activities
• Ensure compliance with Federal and State regulations including HIPAA and PHI handling
• Working cross functionally with the CLIA lab Patient Navigation and Clinical Operations teams to ensure a best-in-class customer and patient experience. Ability to work across team boundaries and collaborate to achieve the best outcome is an essential job responsibility
• Fully remote role (U.S.-based) with occasional travel for trainings meetings or on-site presence at headquarters.
• Travel requirement: up to 5%.

Qualifications

• 4 years of experience in reimbursement or revenue cycle management within a diagnostics company laboratory or commercial payer environment
• Bachelors degree or equivalent experience
• Experience with Xifin Quadax or Telcor preferred
• Strong knowledge of medical benefit structures including Federal State PPO HMO and indemnity plans
• Working knowledge of CPT ICD-10 and HCPCS coding as well as LCD/NCD coverage and reimbursement guidelines
• Strong problem-solving skills with attention to detail and follow-through
• Excellent verbal and written communication skills; strong customer service orientation
• Effective time management skills and ability to adapt in a fast-paced environment
• Self-starter who can work independently and manage competing priorities

Compliance Responsibilities

Health Insurance Portability and Accountability Act (HIPAA) is a federal law that describes the national standards to protect sensitive patient health information from being disclosed without the patients consent or knowledge. All roles at Naveris require compliance with legal and regulatory requirements of HIPAA and acceptance and adherence to all policies and standards at Naveris. Personnel acknowledges they are personally responsible for reporting any suspected violations or abuse and are required to complete HIPAA training when joining the company.

Why Naveris

In addition to our great team and advanced medical technology we offer our employees competitive compensation work/life balance remote work opportunities and more!

Naveris is an Equal Opportunity Employer

Naveris is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We dont just accept differences -we celebrate and support them. We do not discriminate in employment on the basis of race color religion sex (including pregnancy and gender identity) national originpolitical affiliation sexual orientation marital status disability genetic information agemembership in an employee organization retaliation parental status military service or other non-merit factor.