Senior Revenue Cycle Specialist

Fulgent Therapeutics LLC; El Monte (CA); Hybrid; USD 52,541 - 68,000; Full time

Job summary

Fulgent Therapeutics LLC in El Monte, CA is seeking a Senior Revenue Cycle Specialist. This full-time position involves resolving complex billing issues and ensuring compliance for optimal reimbursement from insurance carriers.

The ideal candidate will have a High School Diploma or GED and at least 4 years of experience in healthcare billing. Strong communication skills and the ability to work in a fast-paced environment are necessary. This hybrid position starts fully on-site, transitioning after 90 days.

Qualifications

• Minimum 4 years of experience in a complex healthcare billing reimbursement environment.
• Demonstrated commitment, self-motivation, and drive.
• Advanced knowledge of government and private payor reimbursement.

Responsibilities

• Handle correspondence related to insurance or patient accounts.
• Identify trends to prevent reimbursement issues.
• Research and resolve denials to maximize reimbursement.

Skills

Problem resolution

Payment collection

Communication skills

Advanced knowledge of reimbursement

Interpersonal skills

Ability to work under deadlines

Education

High School Diploma or GED

Job description

Job Details

Level: Experienced • Location: El Monte - CA 91731 • Position Type: Full Time • Education Level: High School • Salary Range: $52,541.00 - $68,000.00 per year • Job Category: Biotech

Position Summary

Senior Revenue Cycle Specialist

This is a hybrid on-site position at our offices based either in El Monte, CA or Coppell, TX. Per current policy, the first 90 days of employment will require fully on-site attendance. After successful completion of the probationary period, new hires may transition to a hybrid schedule of 2 - 3 days on-site per week. This policy is subject to change at the discretion of Inform Diagnostics executive leadership.

Position Description

Senior Revenue Cycle Specialists are responsible for problem resolution and payment collection of complex billing transactions. They utilize expert problem‑solving skills to resolve complex billing issues, unpaid claims, and customer complaints, taking all steps and coordinating corrective action of a multi‑functional nature to ensure full resolution of prompt payment.

Key Job Elements

• Handle correspondence related to insurance or patient accounts, contacting insurance carriers as needed to achieve maximum payment and identify issues and corrective action.
• Identify trends, take action to prevent reimbursement issues and delinquent accounts, and collaborate with leadership and stakeholders to recommend solutions.
• Ensure bills are compliant, determine appropriate steps, and communicate critical information to insurance companies, patients, and leadership verbally and in writing, to resolve concerns in a timely manner and settle accounts in full.
• Communicate with carriers, patients, and management at all levels to secure maximum payment/resolution, and resolve issues or changes to achieve profitability.
• Acquire knowledge of payor fee schedules and denials.
• Demonstrate in-depth understanding of Medicare, Medicaid, and private payors, including policies and guidelines.
• Research and resolve denials, making appropriate decisions to maximize reimbursement.
• Work aging reports of unpaid claims to resolve claims.
• Execute complex projects and assignments that require advanced knowledge and experience in insurance accounts receivable.
• Assist as needed with related duties and special projects.

Qualifications

• High School Diploma or GED.
• Minimum 4 years of experience in a complex healthcare billing reimbursement environment.
• Advanced knowledge of government and private payor reimbursement.
• Experience with anatomic pathology or diagnostic laboratory a plus.
• Demonstrated interpersonal skills; interact with a wide range of employees, clients, and stakeholders.
• Maintain a high standard of discipline and professionalism.
• Ability to think creatively and initiate new ideas or solutions to business issues.
• Demonstrated commitment, self‑motivation, and drive.
• Ability to work in a fast‑paced, deadline‑driven environment.

Environment

Fulgent Therapeutics LLC is an Equal Employment Opportunity Employer. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. The term “qualified individual with a disability” refers to an individual who, with or without reasonable accommodation, can perform the essential functions of the position.