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Manager of Medical Billing Operations #2543

Grail

Grail

Operations
Durham, NC, USA
Posted on Wednesday, March 22, 2023
GRAIL is a healthcare company whose mission is to detect cancer early, when it can be cured. GRAIL is focused on alleviating the global burden of cancer by developing pioneering technology to detect and identify multiple deadly cancer types early. The company is using the power of next-generation sequencing, population-scale clinical studies, and state-of-the-art computer science and data science to enhance the scientific understanding of cancer biology, and to develop its multi-cancer early detection blood test. GRAIL is headquartered in Menlo Park, CA with locations in Washington, D.C., North Carolina, and the United Kingdom. GRAIL, LLC is a wholly-owned subsidiary of Illumina, Inc. (NASDAQ:ILMN). For more information, please visit www.grail.com.
GRAIL is seeking a Manager of Billing Operations (Front End) who is responsible for managing the quality control of complex customer integrations. This position will be based out of our Research Technology Park (RTP) location, in Durham, North Carolina. The successful candidate will have a meaningful experience leading the Billing Ops team as they research, analyze, and remediate front end errors to ensure prompt payment from customers and payors alike. The Manager of Billing Operations will work closely with our third-party billing partner and management team. This role will also work cross-functionally with a number of key functions including but not limited to Clinical Laboratory, Commercial, Customer Experience & implementation, Finance, and the Customer Service groups to ensure quality, accuracy and efficiencies within billing and reimbursement processes.

You will:

  • Own the QC of complex customer implementations. This involves the following: Scope, prioritize, and lead the implementation process to ensure the setup and customer experience is first-class.
  • Conduct risk assessments and testing to ensure implementations occur seamlessly.
  • Monitor, track, and report to key stakeholders any issues that arise and assist in root cause analysis to resolve issues.
  • Owner of front-end error process resolution in the billing system and its timely remediation.
  • Performs root cause analysis to proactively prevent future errors and provide education to internal and external partners.
  • Supervise the team responsible for:Implementation of customer setups that are outside the traditional processResolving front end errors in the billing system using error accession reporting functions.
  • Assign, monitor and audit the work performed by the team.
  • Support strategic billing initiatives to support the commercial organization.
  • Assist and support the Director, Billing Operations and Reimbursement in the scoping and design of transitioning billing inhouse from billing partner.
  • Provide analytical support to identify patterns, trends, contract payment variance.
  • Review and suggest opportunities for improvement through analysis and the monitoring of metrics in key performance areas to patient, client and third-party payor reimbursement, payor specific behavior and billing compliance.
  • Embody GRAIL values and communicate with others in accordance with these standards.
  • Remain composed in conflict situations and escalate issues when appropriate.
  • Coach and develop team members to support their growth.
  • Display effective and professional communication skills and can navigate meaningful questions and resolve complex problems.
  • Demonstrate a thorough knowledge of GRAIL products and procedures.
  • Assist in the review and development of Standard Operating Procedures (SOPs) and policies.
  • Adhere to SOPs pertaining to medical billing, customer service, and accessioning issue resolution.
  • Abide by PCI, CLIA, CAP, HIPAA, and other state, federal, and regulatory guidelines.

Your background should include:

  • 8+ years of related experience with a bachelor’s degree or equivalent medical billing experience. A minimum of 2+ years of experience successfully managing a billing or operations team in a fast-paced environment.
  • Medical billing and revenue cycle optimization experience within a fast-paced environment and/or managing billing operations at molecular diagnostic or genetic testing companies is a plus.
  • Strong understanding of submission and transaction verification processes for claims.
  • Experience with health plan behaviors in reimbursement and denials is crucial.
  • Must be detail-oriented, organized, self-starting, and have a demonstrated ability to prioritize personal and team wide workloads.
  • Must have strong project management skills.
  • Enjoys working as part of a team in a highly collaborative environment.
  • Excellent written communication skills, including technical computer proficiency in a cloud based environment (Google Docs, Google Sheets etc.).
  • Flexible, team-player with ability to develop standard methodologies for procedures on new assignments.
Based on the role, colleagues may be eligible to participate in an annual bonus plan tied to company and individual performance, or an incentive plan. We also offer a long-term incentive plan to align company and colleague success over time.
In addition, GRAIL offers a progressive benefit package, including flexible time-off, a 401k with a company match, and alongside our medical, dental, vision plans, carefully selected mindfulness offerings.
GRAIL is an Equal Employment Office and Affirmative Action Employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability or any other legally protected status. We will reasonably accommodate all individuals with disabilities so that they can participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation. GRAIL maintains a drug-free workplace.