Regional Lab Billing Specialist

Employment Type:

Shift:

Provideschargeentry, insuranceexpertise, registration, and customer service toassistthe laboratory department and patient and/or client through the revenue cycle for hospital and outreach accounts.

• Maintains functional knowledge of charge entry, CPT, and ICD-10 changes, coding practices, and insurance terminology.

• Entersdaily department charges, credit or add charges.

• Monitorsreportsandwork queuesforappropriate charging, coding/modifiers,transferring charges, correctingcharges, reconciling charges, following up on delinquent reports, and problem solving with staff.

• Verifies that the diagnosis codes and corresponding laboratory tests meet the medical necessity criteria to assure claims are paid on the first submission.Work with ordering personnel, includingphysician’soffice staff, to resolve any discrepancies and provide education.

• Responsible for updating patient registrations as needed byutilizinghospital and laboratory policies and procedures.

• Keeps abreast of insurance carrier rules and changes byparticipatingin carrier specific education opportunities and email notifications.

• Meets charge posting deadlines andtimelyreviews/resolves accounts holding for review/additional information/correction.

• Works proficiently in EPIC andXIFIN’s systemto manage workqueues supportingtimelyclaims processing,clientor patient billing.

• Assistswith the development and maintenance of departmental policies and procedures.

• Understands andutilizescomputer billingsystemandmaintainsknowledge of industryregulations asrelated to hospital-based billing and outreach laboratory billing.

• Acts asresourcefor billing system functionality, andidentifiesbilling questions/concerns, pursuing and communicating resolution, asappropriate.

• Serves as a patient advocate in promoting clarity and understanding toefficiently and courteously answer client phone callsregardingbilling,pricingand CPT codes.

• Providesrecommendations tooptimizerevenues.

• Serves as a resource person to laboratory staff and customers.

• Participates in meetings and on committees asrequiredor assigned.

• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and proceduresin order toensure adherence in a manner that reflects honest, ethical, and professional behavior.

General Requirements:

• High School or GEDrequired.

• One year experience with healthcare billing and coding preferred.Experience in accounts receivable or bankingalsoconsidered.

• Associates Degree or Bachelor’sdegree preferred.

• Laboratory billing experience preferred.

• Basic knowledge ofthird partypayor, insurance, and regulatory requirements preferred.

• Working knowledge of computer information systems thatutilizeseveral computer applications concurrently.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.