Billing Subject Matter Expert II - Abbott Laboratories : Job Details

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues serve people in more than 160 countries.

Job Title

Billing Subject Matter Expert II

Working at Abbott

At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You'll also have access to:

• Career development with an international company where you can grow the career you dream of.
• Free medical coverage for employees* via the Health Investment Plan (HIP) PPO
• An excellent retirement savings plan with a high employer contribution
• Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor's degree.
• A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune.
• A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists.

The Opportunity

This position works onsite at our Livermore, CA location in the Abbott Heart Failure, Acelis Connected Health business. Our Heart Failure solutions are helping address some of the world's greatest healthcare challenges.

What You'll Work On

• Review, weekly and monthly key metrics to identify trends or areas of focus; work with Management to develop, document, and implement action plans to address issues.
• Identify payer trends and or root cause of billing or claim exceptions; take appropriate steps to resolve and/or escalate issues to minimize bad debt.
• Identify and interpret policies related to exceptions.
• Determine and apply appropriate business action in absence of policies or in cases of ambiguity.
• Escalate issues as needed; provide recommendations.
• Act as resource for teammate's questions and assist with issues of focus and problematic payer issues. Train new teammates
• Identify training opportunities to improve individual and team performance; perform one-on-one and group training as needed.
• Recommend changes on collection teams, tools, policies and procedures.
• Perform all close reconciliation approvals and related activities to ensure timely submission of primary, secondary and tertiary insurance claims. Serve as a subject matter expert.
• Review and approve adjustments and claim appeal submitted by Specialist of Patient Accounts.
• Conduct quality assurance reviews of work output and provide feedback to teammates and management; offer suggestions for improvement.
• Ability to manage and lead multiple projects, meet deadlines, and adjust priorities appropriately in a high paced work environment. Support department initiatives.
• Strong analytical skills, follow through; with the ability to seek underlying assumptions through probing, questioning, listening, and problem solving.
• Ability to interact positively with all levels of the company.
• Maintain confidentiality of all patients, teammate, and company information in accordance with HIPPA regulations and policies.
• Know, understand, and follow Abbott's teammate handbook, employment policies, safety and security policy and procedures.
• Other duties and responsibilities as assigned including but not limited to:
  • Consistent, regular, and punctual attendance as scheduled.
  • Overtime may be required to ensure timely completion of tasks and required duties.
  • Attend team meetings, phone conferences, and training as needed.
  • Know, understand, and follow department or company procedures.

Required Qualifications

• Requires a High School Diploma or equivalent.
• Years of Experience: 3-5 years
• Proficiency in medical terminology, healthcare billing codes (CPT, HCPCS, ICD) and payer policies.
• Proficiency with healthcare management software (such as XiFin, Telcor, Carevoyant, or Quad X), claims processing systems, Salesforce or other CRM system, Electronic Health Records (EHR), Electronic Medical Records (EMR), insurance websites and Microsoft suite.
• Understanding of regulatory compliance and insurance reimbursement processes is essential.
• Previous experience in healthcare billing, coding, claims processing, particularly in diagnostic laboratory services, durable medical device (DME) is highly valued.
• Must have the ability to work independently with minimal supervision.
• Capability to identify issues and develop effective solutions.
• Must be able to maintain a professional and confidential working environment.
• Must be able to analyze, summarize and provide detail s of findings when needed.
• Strong written and verbal communication skills.

Preferred Qualifications

• Medical or coding degree or diploma preferred.
• Previous RCM audit experience is a plus.

Apply Now

* Participants who complete a short wellness assessment qualify for FREE coverage in our HIP PPO medical plan. Free coverage applies in the next calendar year.

Learn more about our health and wellness benefits, which provide the security to help you and your family live full lives: www.abbottbenefits.com

Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer, committed to employee diversity.

Connect with us at www.abbott.com, on Facebook at www.facebook.com/Abbott, and on X @AbbottNews.

The base pay for this position is $27.00 – $54.00 per hour. In specific locations, the pay range may vary from the range posted.