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Billing & Reimbursement Associate

Cambridge | Massachusetts | United States

About Foundation Medicine

Foundation Medicine, Inc. (FMI) began with an idea—to simplify the complex nature of cancer genomics, bringing cutting-edge science and technology to everyday cancer care. Our approach generates insights that help doctors match patients to more treatment options and helps accelerate the development of new therapies. Foundation Medicine is the culmination of talented people coming together to realize an important vision, and the work we do every day impacts real lives.

About the Job

The Billing & Reimbursement Associate, Process Improvement and Preliminary Billing is primarily responsible for preparing, receiving and reporting orders for preliminary and final submissions to the billing vendor. The Billing Associate works on daily queues of incoming cases to review for complete and accurate billing information in order to determine the party responsible for payment for submission to the billing vendor. Orders which are incomplete or inaccurate require the Billing Associate to reach out to the ordering facility to obtain and correct the information. The position also participates in process improvement projects such as the development of system automation, Standard Operating Procedures (SOPs), and may interface with customers as needed.

Key Responsibilities

• Complete preliminary billing activities within multiple billing applications, including:

  • Document review;
  • Data entry; and,
  • Case submission to FMI’s billing vendor.

• Communicate with internal and external clients to obtain missing billing information.

• Manage domestic self-pay accounts:

  • Investigate missing information prior to pursing payment collection; and,
  • Reach out to patients directly to obtain missing or payment information.

• Participate in process improvement projects to advance the business:

  • Trainings;
  • SOPs; and,
  • System Development.

• Review and enter supplemental test charges to the billing vendor's system(s).

• Coordinate with Sales and Billing Operations to manage billing preferences and education opportunities for ordering clients.

• Process and complete prior authorizations for third party insurance carriers.

• Coordinate the receipt of Advance Notice forms from patients as required by payers.

• Answer incoming calls and e-mails to address internal and external inquiries.

• Manage department email in-boxes to resolve inquiries and complete timely dispatch or escalation.

• Process credit card and other payment submissions into billing systems.

• Educate patients on financial assistance program and assist them with the application process.

• Ensure financial assistance needs are addressed and respond to patient concerns regarding benefits and coverage determinations.

• Ad hoc request and special projects as necessary.

Qualifications

Basic Qualifications

• High School Diploma or General Education Degree.

• 1+ years of customer service experience and/or professional office experience.

Preferred Qualifications

• Bachelor’s Degree.

• Proficiency in Microsoft Office Suites.

• 1+ years of professional of experience within medical billing and/or of experience in a patient-centric role.

• Experience:

  • with Prior Authorization and Advance Beneficiary Notices.
  • working with a goal-oriented team to meet deadlines.
  • independently prioritizing and coordinating daily activities.
  • receiving and applying feedback from peers and supervisors.

• Excellent organizational skill set.

• High level of accuracy and attention to detail.

• Demonstrated ability to interact and communicate professionally, both orally and written, with internal and external customers.

• Understanding of HIPAA patient confidentiality standards for medical and financial information.

• Commitment to meeting deadlines, and to reflecting FMI's values: patients, passion, innovation, and collaboration.

Equal Opportunity and Affirmative Action Plan Employer

Foundation Medicine is proud to be an Equal Opportunity and Affirmative Action employer and considers all qualified applicants for employment without regard to race, color, religion, sex, gender, sexual orientation, gender identity, ancestry, age, or national origin. Further, qualified applicants will not be discriminated against on the basis of disability or protected veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. See also FMI’s EEO Statement and EEO is the Law and Supplement . If you have a disability or special need that requires accommodation, please let us know by completing this form . (EOE/AAP Employer)

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