Experienced Laboratory Billing Specialist.

Starting Pay Based on EXPERIENCE & EDUCATION! Show us what you have to offer.
Overview: Review lab encounters for appropriate demographic, insurance, and testing information.
Screens encounter for valid ICD-10 diagnosis codes, makes appropriate requests from clients for any encounters that need to be reviewed for valid ICD-10 following compliance guidelines.
Applies appropriate modifiers to lab encounters and enters charges and CPT codes for lab sendout testing.
Embodies the Solutions Lab and Healthcare’s Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision, and values.
Qualifications: _Education:_ * Associate’s degree in science, business, or related discipline required.
Two years experience in billing/coding, working with laboratory-related applications, or related experience may be considered instead of degree.
_Experience:_ * Minimum three years experience in a laboratory setting utilizing laboratory information systems with at least one year of billing and coding experience required.
_Other Knowledge/Skills/Abilities:_ * Knowledge of ICD-10, CPT, HCPC, and modifier codes is required.
* CPT coding and lab modifier training within 1 year.
* Ability to work in the following programs: Microsoft Excel and Word Responsibilities: * Applies modifiers to all Pathology and Cytology lab testing by utilizing a complete review of the daily charge log from the lab system.
* Applies modifiers to all Clinical Lab Testing utilizing specific logs built for like and unlike CPT code review.
* Applies all charges for lab send-out testing.
Includes monitoring all reference lab fee schedules and invoices to ensure pricing is up to date and updating pricing in hospital billing system for all sendouts without chargemaster code set up.
Splits charges appropriately and applies correct test description and modifiers in hospital billing system.
* Embodies the Solutions Management Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values: * Correctly interprets and inputs all necessary demographic, insurance, and testing information into the laboratory and registration computer systems.
* Screens lab outreach and outpatient orders for appropriate ICD-10 diagnosis codes utilizing 3M.
* Screens lab outreach and outpatient orders for appropriate CPT codes for Medical Necessity utilizing NDAS software.
* Follows-up with physician’s office on any invalid ICD-10 or inappropriate ICD-10 diagnosis codes to ensure prompt payment of encounter.
* Responds to client inquiries concerning billing discrepancies, appropriate ICD-10 Diagnosis coding and accurate transmittal of CPT-4 Codes to the client sites.
* Evaluates all ABN’s received and ensures ABN’s are valid, flagged in the registration system, and scanned into the medical record.
* Monitors daily worklists of pending diagnosis reviews from coding department.
* Promotes an attitude of teamwork and effective communication and rapport with managers and staff of the Laboratory and Memorial Health System.
* Works closely with laboratory information systems analysts to identify problems related to the Outreach computer programs.
* Responds to basic requests from Patient Financial Services for review of CPT codes, ICD- 10 codes and patient questions regarding lab billing * Understands all insurance carrier codes and policy numbers for all MMC payers.
Knowledge of charity care programs offered by MMC.
* Ability to credit, reverse charges, and make all other required updates to ensure a lab encounter is compliant.
* Reviews specific daily reports to reconcile any issues holding up an account for billing including date of service issues.
* Monitors specific logs for diagnosis review i to ensure coding has a valid diagnosis to code order.
* Receives all emails from Patient Financial Services requesting an encounter review.
This could include CPT code review, modifier review, payment denial, or requesting additional documentation for encounter.
* Provides support for Lab leadership.
* Conforms to Memorial Medical Center strategic plan and philosophy regarding the Guest Relations Program.
* Performs other related work as required or requested.
Job Type: Full-time Pay: $49,921.
92 - $56,162.
16 per year Benefits: * 401(k) * Dental insurance * Health insurance * Life insurance * Vision insurance Schedule: * 8 hour shift * Monday to Friday Work Location: In person