Reimbursement Specialist Insurance Verification
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Job Location:
Waltham, MA - USA
Monthly Salary:
Not Disclosed
Posted on:
6 hours ago
Vacancies:
1 Vacancy
Job Summary
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 Insurance Verification 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 detail-oriented Reimbursement Specialist Insurance Verification to join our team and support front-end reimbursement activities. While Naveris partners with an outsourced RCM vendor this role focuses on ensuring accurate insurance verification benefits investigation and documentation to support timely and accurate billing 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 insurance verification and front-end reimbursement readiness. This position is remote.
- Verify patient insurance coverage eligibility and benefits by contacting payers and using electronic verification tools
- Accurately enter and maintain patient demographic and insurance information in billing systems and payer portals
- Obtain medical records or supporting documentation for priority payers when not received with the order
- Collaborate with internal teams healthcare providers insurance companies and patients to gather information needed for accurate billing
- Identify front-end delays or issues impacting reimbursement and recommend solutions
- Maintain detailed and accurate documentation of eligibility verification and payer communications
- Communicate with patients to explain insurance-related processes benefit coverage EOBs and financial responsibility for non-clinical inquiries
- Maximize utilization of systems tools and resources to support front-end reimbursement activities
- Review payer correspondence and EOBs to validate coverage determinations and identify discrepancies related to eligibility or benefits
- Ensure compliance with all Federal and State billing regulations and company policies including HIPAA
- Fully remote role (U.S.-based) with occasional travel for trainings meetings or on-site presence at headquarters.
- Travel requirement: up to 5%.
Requirements
- 4 years of experience in reimbursement insurance verification 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 understanding 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 guidelines
- Strong problem-solving skills with attention to detail judgment and follow-through
- Excellent verbal and written communication skills with a strong customer service orientation
- Strong troubleshooting organizational and time-management skills
- Ability to adapt to changing business needs
- Self-starter who can work independently
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 origin political affiliation sexual orientation marital status disability genetic information age membership in an employee organization retaliation parental status military service or other non-merit factor.
Required Experience:
Manager
Key Skills
- Sales Experience
- Time Management
- Marketing
- Customer Service
- Communication skills
- Retail Sales
- Business Management
- Outside Sales
- Telemarketing
- Insurance Sales
- Medicare
- Phone Etiquette
About Company
Naveris develops highly sensitive blood tests that identify viral cancers significantly earlier than scans or traditional biopsies.
