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Insurance Billing & Compliance Leader

Waltham, Massachusetts

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Responsibilities

Location Waltham, MassachusettsUS Job ID JR-014893

Insurance Billing & Contracts Leader

Summary

Insurance Billing & Contracts leader will be responsible for developing billing process policies and procedures consistent with medical and clinical laboratory practices and applicable law and regulation, and providing training and compliance support for same.  Additionally, will be responsible for reviewing and negotiating medical insurance payor contracts, service provider contracts relating to billing and/or collection processes.  Familiarity with False Claims Act and Anti-Kickback Statute strongly desired.

Responsibilities

Contracts

  • Ensure consistency of contract terms
  • Review service contracts with customers
  • Review service contracts from vendors
  • Review and negotiate insurance payor contracts
  • Coordinate cross-functional (legal, finance, lab management) for customer and contract review and compliance efforts
  • Understand and adhere to Lab Service agreements

Insurance Billing

  • Liaison between Insurance companies to reconcile billing terms and complex billing situations
  • Understand and adhere to billing terms from Insurance carriers
  • Develop standard and compliant billing practices to ensure accountability to corporate, payor and regulatory requirements

Basic Qualifications

  • Bachelors Degree
  • 5+ years in either health insurance billing OR contracts role

Preferred Qualifications

  • Strong understanding of insurance billing and submission processes and regulations
  • Experience in Lab Service OR Medical Diagnostics
  • Ability to work in a matrix organization
  • Strong communication skills
  • JD preferred
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PerkinElmer is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability status, age, or veteran status or any other characteristics protected by applicable law. PerkinElmer is committed to a culturally diverse workforce.

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