Eurofins Transplant Genomics Inc. (“ETG”) is a molecular diagnostics company committed to improving organ transplant outcomes with non-invasive serial monitoring guided by biomarkers. ETG’s product portfolio of both individual and combined whole blood gene expression and donor derived cell-free DNA testing is capable of reliably ruling out subclinical kidney rejection and acute rejection in kidney transplant patients. In addition to kidney transplantation testing, our newest product for liver transplant patients is a blood-based biomarker assay designed to rule out rejection as immunosuppression therapy is optimized. Basic Function and Scope of Responsibility:The Billing Specialist effectively communicates the estimated financial responsibility of the member and obtains prior authorization for billing. To achieve this, the Specialist is responsible for verifying the receipt of test order IDs, checking the member's insurance and benefits, communicating the member's financial responsibilities to the patient and/or sales team, submitting prior authorization requests through payor websites, fax or phone, and procuring medical records or documentation as required by insurance prior authorization or appeals. They must also keep up to date with changes in insurance policies and pre-certification requirements and maintain current knowledge of payor websites and utilization. Reviewing claims in Xifin and resubmitting them to payors for Pre-authorization reviews is also part of their job. They are responsible for ensuring that pre-certification, authorization, and referrals are in place for all cases. Entering payor and responsible party information accurately into the accounting system is crucial. The Specialist must also possess exceptional task prioritization skills and the ability to review tasks efficiently and thoroughly. In case of necessity, the Specialist should cross-train in various duties within the Billing department. Research is also a crucial aspect of this role, and the Specialist must follow up and know how to appeal prior authorization rejections/denials. This role also includes monitoring FAP's.