Valar Labs is a well funded, fast-growing AI diagnostics startup backed by leading VCs revolutionizing oncology and urology through cutting-edge technology and innovation. We are dedicated to improving patient outcomes through the development and deployment of novel AI-driven diagnostics to reduce treatment uncertainty for oncologists and patients. Our team comprises accomplished researchers, and passionate individuals committed to shaping the future of healthcare.
Valar’s Manager of Billing Operations will be responsible for setting up and leading the billing operations of Vesta, the first histology-based test to predict response to BCG in bladder cancer. This pivotal role involves creating efficient billing systems, managing and optimizing billing processes, and ensuring compliance with healthcare regulations. You will work closely with cross-functional teams, including sales, marketing, lab operations, market access, and medical affairs, to optimize billing procedures and enhance financial performance.
Key Responsibilities:
Develop and implement billing operations from the ground up, creating scalable processes to support the company’s growth.
Lead the entire billing cycle from claims submission to payment processing as well as troubleshoot EOBs, appeal non-covered and low pay claims, follow-up on claims, and drive positive coverage determinations through external appeals.
Administer patient assistance programs, ensuring patients have access to necessary support for treatment affordability.
Manage documentation for appropriate payer communication, correspondence, and insurance claim research
Ensure compliance with medical billing regulations and standards, staying updated with changes in billing practices and healthcare laws.
Negotiate and manage contracting with insurance providers to secure favorable terms and maintain relationships.
Analyze billing metrics and financial data to report on performance and identify opportunities for improvement.
Qualifications:
Minimum of 5 years of experience with medical billing, preferably in independent diagnostic or medical laboratories.
Experience working with a broad range of payers and have appealed to state level agencies or external level review with IROs.
Experienced with laboratory billing, billing software, EDI enrollment, merchant solutions, payer portals and national as well as regional payers throughout the country.
Excellent understanding of coding including ICD-10 and CPT codes.