Patient Advocate and Accounts Receivable Specialist

Company Description

Machaon Diagnostics is a clinical reference laboratory and contract research organization (CRO) that focuses on diagnosing, treating, and monitoring hemostatic and thrombotic conditions, complement-mediated disorders, and rare genetic diseases. Our mission is to save more lives with lab tests. Originating from a collaboration of four laboratory scientists, the team now includes clinicians, scientists, consultants, and technologists with over 400 years of collective expertise. We provide esoteric and routine testing services to a broad clientele, including community hospitals, university medical centers, clinics, commercial laboratories, and research facilities, as well as biotechnology, pharmaceutical, and medical device companies. Our primary goal is to deliver high-quality testing with industry-leading speed.

Role Description

This is a full-time, on-site role located in Berkeley, CA for a Patient Advocate and Accounts Receivable Specialist. The responsibilities include managing patient accounts, advocating for patient needs, handling customer service inquiries, and managing cases. Additionally, the role involves critical thinking and effective communication in a medical setting. The specialist will work closely with patients, healthcare providers, and internal teams to ensure the best possible outcomes for those requiring our diagnostic services.

Patient Advocacy, Insurance Billing & Sponsored Testing Coordination (Outpatient Focus)

· Enroll patients in sponsored testing programs and coordinate the delivery of outpatient samples to the laboratory for urgent testing.

· Submit claims to insurance providers accurately and promptly. Maintain consistent communication with and advocacy for patients.

· Obtain authorizations from insurance entities and provide good faith estimates to patients when necessary.

·  Communicate test requirements, billing processes and available programs to healthcare providers via phone and email.

Client Account Management and Onboarding (Insurance) Institutional Focus

        Coordinate the onboarding of new clients and healthcare agencies that send testing to Machaon Diagnostics.

·        Ensure accurate setup of client accounts, including correct contact information for billing, purchase order details and banking information when necessary.

·        Verify that invoices and other documentation are routed to the appropriate contacts.

·        Collaborate with the laboratory team to determine billing status for incoming samples.

Revenue Cycle & Accounts Receivable

·        Receiving payments into invoices/processing checks.

·        Follow up on past-due invoices and communicate with clients to resolve outstanding balances.

·        Provide test cost information and billing details to healthcare providers upon request.

·        Participate in ad hoc projects and cross-functional initiatives as assigned to support business operations and continuous improvements to Finance department processes.

Experience Requirements

·        Demonstrate an empathetic and patient-focused approach in all activities and interactions.

·        Excellent written and oral communication skills. Extensive experience communicating by phone is highly preferred. Attention to detail is imperative in this role.

·        Ability to multitask, show initiative, work in a fast-paced environment, and always be solutions oriented.

·        Bilingual (English/Spanish) is highly valued. Demonstrate the ability to effectively communicate with all patients, clients, providers, and fellow employees.

·        Demonstrate high degree of integrity, enthusiasm, and initiative daily.

Constant adherence to HIPAA compliance and patient confidentiality requirements

Education Requirements

Required:

1.   Bachelor’s degree or equivalent in healthcare administration, business, or finance-related field preferred.
2.   Minimum 2 years of experience in patient coordination, billing, receivables, and client services in a healthcare setting.
3.  Proficiency with medical billing, including CPT codes, payer portals, EOBs, and healthcare billing workflows.
4.  Proficiency with Microsoft Office and data entry/reporting.

Preferred:

1.  Experience in a laboratory or diagnostic testing setting.
2. Experience with sponsored testing and other financial assistance programs.
3. Experience in high leverage collections.