Introduction to Castle Biosciences
Castle Biosciences Inc. is a leading biotech company that has been recognized as one of the Top Workplaces USA for the third consecutive year. We are committed to empowering healthcare providers and patients with innovative, laboratory-developed tests that inform disease management and treatment decisions. Our mission is to improve patient outcomes by revealing the unique biology of each individual through scientific rigor. We believe that every employee at Castle has an impact on patient care, and we strive to create a work environment that is both challenging and rewarding.
Job Overview
We are seeking an experienced Reimbursement Specialist to join our team, with a focus on claim denial and appeal. As a Reimbursement Specialist, you will play a critical role in resolving denied insurance claims for laboratory services by providing payers with requested or additional documentation, initiating the appeal process on behalf of the patient, and delivering the highest level of customer service to both internal and external customers. This is a remote opportunity, with a start date prior to March 13, 2025.
Key Responsibilities
- Review Explanation of Benefits (EOBs), electronic remittance advice, and denial letters to identify and resolve claim issues
- Assign appropriate ANSI codes and take necessary action within the billing system
- Place calls to insurance companies to obtain missing information or determine the status of submitted claims as needed
- Read and interpret medical record documents and payer medical policies to ensure that key "medical necessity" criteria are documented by the clinician
- Create custom appeals with well-supported arguments to ensure denials are overturned based on payer medical policy or state laws
- Provide excellent customer service to both internal and external customers, including patients, healthcare providers, and insurance companies
- Work collaboratively with the reimbursement team to resolve claim issues and achieve reimbursement goals
Essential Qualifications
- High School Diploma or equivalent GED or equivalent work experience
- Two years of health insurance billing experience with experience in identifying and resolving claim issues for procedures/tests
- Working knowledge of various payers' designations of authorized representative forms
- Experience handling a high volume of claims work on a daily basis (30 plus denials for claims per day)
- Proficient in Microsoft Excel, Word, and Outlook
- Strong analytics and problem-solving skills
- Excellent customer service skills
- Typing speed of 30 or more words per minute, with 90% or greater accuracy
- One year minimum experience as a reimbursement specialist, with a role with one company
- Actively displays behaviors that support the mission, vision, and values of Castle Biosciences
Preferred Qualifications
- Experience working in a biotech or healthcare setting
- Knowledge of medical billing and coding principles
- Experience with electronic health records (EHRs) and practice management systems
- Certification in medical billing or coding (e.g. CPC, CPB, or CMRS)
Skills and Competencies
- Strong analytical and problem-solving skills, with the ability to interpret complex data and make informed decisions
- Excellent communication and customer service skills, with the ability to effectively interact with patients, healthcare providers, and insurance companies
- Ability to work in a fast-paced environment, with a high volume of claims and deadlines to meet
- Strong attention to detail, with the ability to accurately review and process claims
- Ability to work collaboratively as part of a team, with a focus on achieving reimbursement goals and improving patient outcomes
Career Growth Opportunities and Learning Benefits
At Castle Biosciences, we are committed to the growth and development of our employees. As a Reimbursement Specialist, you will have the opportunity to develop your skills and knowledge in medical billing and reimbursement, with a focus on claim denial and appeal. You will also have the opportunity to work collaboratively with our team of experienced reimbursement specialists, and to contribute to the development of our reimbursement strategies and processes.
Work Environment and Company Culture
Castle Biosciences is a dynamic and growing company, with a strong commitment to our mission and values. We believe in creating a work environment that is both challenging and rewarding, with opportunities for growth and development. Our company culture is built on a foundation of integrity, respect, and kindness, and we strive to create an environment that is inclusive and supportive of all employees.
Compensation, Perks, and Benefits
We offer a competitive salary and benefits package, including:
- Excellent Annual Salary + Achievable Annual Bonus Potential 20% of Salary
- 20 accrued PTO Days annually
- 401K with a 100% Company match of up to 6% of your allowable Contribution, and No Waiting Period
- 3 health care plan options, with very low premium cost + Company HSA Contribution with HDHP option + Company Stock Grant Upon Hire
Conclusion
If you are a motivated and experienced reimbursement specialist, with a passion for delivering excellent customer service and improving patient outcomes, we encourage you to apply for this exciting opportunity. At Castle Biosciences, we are committed to creating a work environment that is both challenging and rewarding, with opportunities for growth and development. Join our team and contribute to our mission of improving patient outcomes through innovative, laboratory-developed tests.
How to Apply
To apply for this position, please submit your application through our website. We look forward to hearing from you!
Apply Now