Billing Associate at Personalis, Inc.

Fremont, CAFull-timeClinical BillingPosted 5 days ago

About the Role

At Personalis, we are transforming the active management of cancer through breakthrough personalized testing. We aim to drive a new paradigm for cancer management, guiding care from biopsy through the life of the patient. Our highly sensitive assays combine tumor-and-normal profiling with proprietary algorithms to deliver advanced insights even as cancer evolves over time. Our products are designed to detect minimal residual disease (MRD) and recurrence at the earliest timepoints, enable selection of targeted therapies based on ultra-comprehensive genomic profiling, and enhance biomarker strategy for drug development. Days Onsite: Monday & Tuesday (Hybrid) Summary: The Billing Associate holds a pivotal and critical position in supporting Personalis' overarching business objectives. This dynamic role is fundamentally responsible for establishing the foundation to maximize reimbursement for the company's proprietary Next Personal DX test. The core function of this position is to optimize the revenue cycle by meticulously managing the order intake and claim submission processes. A primary responsibility of the Billing Associate is to ensure the absolute accuracy and completeness of the order intake process, which is the initial stage of the revenue cycle. Following this, the Associate is tasked with the precise preparation and submission of "clean claims"—claims free of errors, documentation deficiencies, or missing information—thereby accelerating payment and reducing denials. Furthermore, this role is essential in reinforcing Personalis' deep-seated commitment to patient access to high-quality healthcare. The Billing Associate serves as the primary administrator of the NeXT Access financial assistance program. This involves communicating program details to eligible patients, processing applications, and managing the financial assistance workflow to mitigate the financial burden on patients, ultimately ensuring that more individuals can benefit from the Next Personal DX test regardless of their financial circumstances. Who You Are You are eager to launch a career in medical billing and the broader revenue cycle management (RCM) process, leveraging your foundational understanding of health insurance benefits. You are focused on mastering RCM best practices, including client and third-party billing, payer structures, claims processing, and specific reimbursement requirements. Your defining trait is a strong attention to detail, which is essential for ensuring the high level of accuracy needed for successful billing outcomes. Furthermore, you possess strong analytical skills and enjoy investigating and troubleshooting issues and discrepancies. This passion for problem-solving is vital for continuous process improvement and maximizing reimbursement. You are known for providing excellent customer service to both internal and external stakeholders, communicating effectively through both written and verbal channels. You thrive in a team environment, actively contributing by learning from others, raising potential system or customer issues during team meetings, and proposing ideas for continual business optimization. Responsibilities: <ul> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Support the claims & order entry processes </li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Support the order entry process by ensuring all billing data is available for order entry</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Determine  the coverage status of test orders by reviewing clinical criteria</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Obtain medical records and other missing information</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Assign the proper test codes based on payer and clinical criteria.</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Transfer insurance claims and billing data to billing software (e.g., XIFIN).</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Resolve claim and frontend billing errors and manage assigned correspondence queues.</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Verify patient benefits and insurance eligibility</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Engage with payers to request prior authorization for tests</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Administering & supporting patient financial assistance for the NeXT Access program</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Arrange payment plans and timelines for payments</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Collaborate with the Client Experience team, our commercial partners, and the downstream Billing Operations team</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Support activities related to integrating the billing system with LIMs and other IT systems.</li> </ul> Qualifications: <ul> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;"> Required Qualifications: <ul> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">0-2 years of experience in medical billing or a related field</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">High school diploma or equivalent GED.</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Exceptional phone etiquette for communication with patients, physicians, and insurance representatives.</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Proficient computer skills.</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Ability to analyze problems and strategize for better solutions.</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Proven ability to multitask, prioritize, and manage time efficiently.</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Self-motivated and self-directed, with the ability to work independently.</li> </ul> </li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;"> Preferred Qualifications: <ul> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Associate Degree in Business, Marketing, Accounting, Healthcare Administration, or a related field. Including healthcare certifications.</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Experience of familiarity with medical insurance benefits and regulations.</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Experience with Google Suite.</li> <li style="font-family: helvetica, arial, sans-serif; font-size: 12pt;">Working knowledge of billing software (XIFIN)</li> </ul> </li> </ul> The hiring range for this position is $25.50 to $31.50 per hour, which may factor in various geographic regions. The base pay actually offered will take into account internal equity and also may vary depending on the candidate’s geographic region, job-related knowledge, skills, and experience among other factors. Our full-time regular positions also include an annual performance-based bonus (or a sales incentive plan) and long-term incentive units (equity) provided as part of our compensation package, in addition to a full range of medical, financial, and/or other benefits, dependent on the level and position offered. Personalis is an equal opportunity employer and is committed to the full inclusion of all individuals. As part of this commitment, Personalis will ensure that persons with disabilities are provided with reasonable accommodations. If you need an accommodation to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please let your recruiter know, if/when they contacts you. Protecting Our Candidates: At Personalis, we value your security. Please note that all official correspondence from our team will come exclusively from @<a href="http://personalis.com" target="_blank">personalis.com</a> email addresses. We will never ask for personal financial information or conduct interviews over text or chat platforms. If you receive a suspicious request, it is likely a scam. We are committed to a safe recruitment experience and actively work with authorities to investigate and prosecute cyber crimes targeting our community. Personalis is an Equal Opportunity Employer/Minorities/Females/Veterans/Disabilities. Personalis offers a competitive compensation package and benefits including medical, dental, vision, 401(k) match, ESPP, tuition reimbursement, sick/vacation time, commuter benefits/ EV charging stations, onsite gym, and wellness benefits. (For US only, benefits in other countries may vary.)    #LI-Hybrid #LI-JT1

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