Lab Billing & Compliance Specialist

General Description:

Under general direction, works within the Laboratory to independently facilitate and oversee billing and coding for compliance. Performs all charge audit functions for the system laboratories including General Laboratory, Microbiology, Pathology, and Transfusion Services by utilizing the EHR billing work queues. Monitors billing processes and makes corrections as needed. Manages the timely and accurate posting of laboratory charge information for both patient and client-billed encounters. Answers client billing inquiries and resolves laboratory billing issues. Can assist in preparing and maintaining outreach client contracts. Serves as a resource for compliance questions.

Essential Responsibilities:

Responsibilities listed in this section are core to the position. Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position.

• Performs billing and/or coding compliance audits as assigned
• Ensures charges follow regulatory compliance billing guidelines
• Possesses working knowledge of DRG/OPPS payment systems and impact of ICD-10/CPT/HCPCs on physician and facility documentation for lab billing
• Reviews and approves all new and updated contract fee schedules
• Maintains and works all laboratory billing work queues
• Maintains laboratory billing policies
• Works on projects as assigned
• Perform other duties as assigned

Minimum Qualifications:

Education: Associate's Degree Required

Experience: 3 years of Laboratory experience required

License(s)/Certification(s)/Registration(s) Required: None Required

Knowledge, Skills and Abilities:

• Demonstrated knowledge of navigating billing and EMR systems for laboratory
• Knowledge of Microsoft Office Suite e.g. Word, Excel, PowerPoint
• Ability to manage multiple assignments; work well under pressure; recall information with accuracy; pay close attention to detail
• Excellent verbal and written communication skills; interpersonal relationship and collaboration skillspreferred
• Strong organization skills; strong critical thinking, judgment, and problem-solving skillspreferred

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