Lab Billing & Coding Rep

Position Summary:


The Laboratory Billing & Coding Representative is responsible for accurate and timely billing of Laboratory services. Responsible for understanding medical terminology, patient registration, insurance eligibility, payer rules, CPT/HCPCS bundling, CCI modifiers, and lab-related coding for problem resolution. Responsible for understanding and applying compliance and regulatory guidelines to resolve charge review edits, claim edits, billing-related issues, and assigned work queues. Functions as a lab-billing resource for internal and external parties. This position uses Carle electronic medical record systems and Lab Information System to review clinical encounters and laboratory results.

Qualifications:


EXPERIENCE REQUIREMENTS
Three (3) years Healthcare/Medical experienceProficient computer knowledge related to Microsoft Office applications such as Word, Excel, Outlook, and Teams

SKILLS AND KNOWLEDGE
Knowledge of patient registration, billing processes, medical terminology, and coding applicable to position. Ability to deal with a large volume of work, multitask, easily accept and implement change, and perform computer data entry. Basic/Intermediate Level experience in Microsoft Outlook, Word, Excel, and Teams. Ability to work with others collaboratively, both orally and in writing.

Essential Functions:

• Experience with Lab Billing and Coding/Preferred
• Experience with Epic Registration/Preferred
• Responsible for resolving Lab-related CPT, HCPCS, and applicable ICD-10 inquiries for internal and external parties.
• Responsible for editing laboratory test charges to ensure CPT/HCPCS codes are appropriate for tests being billed and appropriate modifiers are applied. Ensures all charges are corrected when additional tests are ordered, or tests are cancelled at a later date.
• Responsible for researching and resolving assigned billing reports and work queues on a daily basis for registration errors, charge review, claim edits, etc.
• Responsible for understanding and applying compliance, regulatory, and CPT/HCPCS bundling rules for Laboratory billing.
• Facilitates maximization of revenue by ensuring correct coding initiatives and payer-specific guidelines are applied appropriately.
• Works collaboratively with Revenue Cycle, Coding, and other departments to resolve patient or payer-related charge and account inquiries, coding, denials, lab orders, trends, etc.
• Reconciles Referred (send-out) Testing invoices, calculates charges, keys billable services into systems, and reports discrepancies to appropriate internal and external parties.
• Communicates issues and trends to management to maintain departmental compliance and improve processes. Attends and provides input at meetings and trainings.
• Assists with Reference Laboratory billing processes.
• Assists with financial and statistical reports.
• Ensures quick responses to clients and patients regarding billing concerns.
• Ensures daily work assignments are complete by promoting teamwork and good communication.
• Assists with audits, special projects, and annual policy and procedure review process as requested.