Intake & Reimbursement Specialist

INTAKE & REIMBURSEMENT SPECIALIST

THE COMPANY:

Element Science, Inc. is a medical device and digital health company focused on developing solutions at the intersection of clinical-grade wearables, machine learning algorithms, and lifesaving therapies in order to address leading causes of death and hospitalization in patients with heart disease, primarily as they transition from the hospital-to-home. By putting the needs of patients and physicians first, our personalized digital devices, which are designed for function, comfort, and ease-of-use, aim to redefine the paradigm of care for these patients. Our first product, a wearable patch defibrillator, is initially targeted at treating the more than 500,000 patients in the US with an elevated temporary risk of potentially experiencing a lethal heart rhythm. Based in San Francisco, our funders include Third Rock Ventures, Google Ventures, Deerfield Healthcare, Qiming Venture Partners USA, Cormorant Asset Management, and Invus Opportunities.

SUMMARY OF ROLE:

The Intake & Reimbursement Specialist serves as the main liaison between physicians' offices and our healthcare system, responsible for patient setup, demographic data entry, and loading diagnosis codes to support and perform billing procedures.

RESPONSIBILITIES:

• Liaison Duties: Facilitate patient intake and ensure accurate demographic data entry.
• Documentation & Compliance: Gather and verify documentation, ensuring adherence to payer
• Order Processing: Check daily for outstanding tasks, verify DME sales orders, and process patient payments.
• Prior Authorizations: Obtain and manage prior authorizations and eligibility checks.
• Revenue Cycle Management: Handle claim follow-ups, billing stops, denials, and unapplied payments.
• Customer Service: Resolve account discrepancies, reconcile disputes, and assist with billing issues.Provide exceptional customer service to patients and providers through friendly, caring, informative, and professional interactions.Answer inbound calls and return voicemails in a professional and timely manner.
• Billing: Process insurance and non-insurance orders, manage front-end denials, and maintain price tables.Efficiently navigate and utilize the NikoHealth System to set up patients and accurately input physician orders, streamlining administrative workflows and enhancing patient care coordination.
• HIPAA Compliance: Maintain confidentiality and adhere to HIPAA guidelines.Maintain a strong knowledge of guidelines related to HIPAA, OIG Compliance, medical coding, and billing/reimbursement.
• Perform other duties as assigned by management.

QUALIFICATIONS:

• A proven track record of at least 5 years as a certified coding specialist in healthcare billing and reimbursement.
• 3-5 years prior experience in an Intake Coordinator role.
• Completion of an associate's degree, certificate in medical billing, or equivalent professional experience.
• Possession of one or more prestigious certifications such as Certified Professional Coder (CPC), Certified Professional Coder Hospital (CPCH), Certified Coding Specialist (CCS), or Certified Outpatient Coder (COC).
• Experience with medical billing software, NikoHealth a plus!
• Ability to be discreet and maintain the security of patient or customer information.
• Demonstrate professionalism and integrity in all actions, actively promoting and fostering positive relationships on behalf of the company.
• Exceptional capacity for follow-through, organization, and meticulous attention to detail.
• Substantial experience in documentation, billing, and collections processes.

BENEFITS:

Element Science offers a very competitive salary and benefits package including, but not limited to:

• Stock Options
• 90% employer-paid medical, dental, and vision insurance
• Company-paid Basic Life Insurance
• 401(k) retirement plan (Traditional and Roth)
• Competitive Paid Time Off
• Paid Holidays
• FSA (Flexible Spending Accounts)
• HSA (Health Savings Account)
• Employee Assistance Program through PEO

The salary for this exempt-level position will be based on experience and qualifications within an established pay range.

Element Science is an Equal Opportunity Employer. All candidates will be evaluated on the basis of their qualifications for the job in question. We do not base our employment decision on an employee's or applicant's race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, or other non-merit-based factors prohibited by local, state, or federal law.

At this time, we are unable to offer relocation assistance at Element Science.