Revenue Cycle Associate - Collections

Ready to redefine what's possible in molecular diagnostics? Join a team of brilliant, passionate innovators determined to transform healthcare. At BillionToOne, we've built a category-defining, publicly traded company on Nasdaq where transparency fuels trust, collaboration drives breakthroughs, and every contribution moves the needle on our mission to make life-changing diagnostics accessible to all. We don't just aim for incremental improvements; we build products that are 10x better than anything that exists today. With over 700 employees, half a million patients helped, and one of the most successful IPOs in medical diagnostics history behind us, we're just getting started. Our scientists, engineers, sales executives, and visionaries are united by an unwavering commitment to changing the standard of care in prenatal and cancer diagnostics. This is where cutting-edge science meets human compassion, and every innovation you contribute helps remove the fear of the unknown from some of life's most critical medical moments. If you're driven by purpose, energized by innovation, and ready to help shape the future of precision medicine at scale, this is where you belong. We are looking for a Revenue Cycle/Medical Collections Associate to be responsible for focusing on collections and appeals from various Federal, State, Third Party (HMO, PPO, IPA, TPA Indemnity) payers. This is a remote position and will report to the Manager of Reimbursement Operations. The ideal candidate must be able to: (1) Optimize payment reimbursements by reviewing accounts for billing accuracy and health plan coverage. (2) Be persuasive and persistent when following up on claims status, and (3) process an appeal, resubmit/rebill, or forward claims for adjudication as necessary. Responsibilities: Verify claim was submitted to correct insurance. Review/update patient demographics and information for accuracy. Process and validate payor requests and claims via correspondence, remittance advice and EOBs (i.e., identify payment discrepancies, inappropriate requests) Investigate all denied services to determine reason and appeal, if appropriate. Identify and report root causes associated with denials to reduce/resolve issues. Process assigned appeals including submission, tracking, reporting and evaluation of appeal outcomes (i.e., next steps, improved outcomes) Maximize utilization of Billing system, tools and resources to support cash collection activities Review various reports including aging outstanding and denial reports. Comply with Federal and State legislation on all billing related matters. Comply with all Safety, Emergency, Hazard, OSHA, HIPAA, Quality Assurance and Administrative Plans, Policies, Guidelines, Protocol, and Standards. Support and maintain department cash and DSO goals. Qualifications: Minimum of 4+ years specializing in Medical Collections at a diagnostics company, laboratory or other healthcare provider, doing collections from commercial payers. Hands-on experience handling the entire appeals process Must possess detailed knowledge of all medical benefit levels and have a thorough understanding of Federal, State, PPO, HMO, and Indemnity Plans structures. Working knowledge of appropriate coding systems; CPT, ICD-10 and HCPCS, coverage; LCD/NCD and reimbursement associated with such codes. High School Diploma or a Bachelor’s degree from a four-year college or university Strong problem solving skills with ability to streamline and improve processes, use good judgment, attention to detail and follow-through are a must. Excellent customer service skills; excellent verbal and written communication skills Excellent troubleshooting and time management skills, attention to detail, utilizes time in constructive manner Ability to easily adapt to increased business demands Ability to effectively work with and resolve complex accounts billing issues Self-starter, ability to work independently and be self-motivated ... (truncated, view full listing at source)