Primary City / State :

Tucson, Arizona

Department Name :

LTC Client Billing-Ref Lab

Work Shift : Job Category :

Job Category : Revenue Cycle

Revenue Cycle

POSITION SUMMARY

This position is responsible for managing the billing relationship with Laboratory Sciences / Sonora Quest Laboratories and all external and internal customers to maintain, improve, educate and resolve any and all billing services, issues, and processes to assist in addressing concerns for retention and attrition of clients, quality customer service, meeting revenue goals, education and training, and support of the Company’s goals and mission.

All employees are responsible for following the Company’s policies and procedures, following safety standards, and supporting the Company’s goals and mission.

CORE FUNCTIONS

1. Identifies and educates top billing offenders (external clients) who generate a high number of unbillable errors due to multiple reasons-(incomplete billing information), including medical necessity, process / system errors.

Identifies and assists management in developing processes that will reduce the amount errors, while continuing to maintain all compliance policies.

Maintains understanding of policies regarding fraudulent or non-compliant processes whether intercompany or via insurance and government guidelines.

2. Increases profitability through the decrease of errors, working specified projects quarterly and meeting financial goals and metrics.

Keeps apprised of updates to Medicare guidelines, payor contractual requirements denial reasons, modifier updates and reimbursement changes.

Maintains documentation in Salesforce and Xifin for all communication with clients, insurance, Account Managers / Execs, and internal departments.

Receives and responds to billing requests.

3. Standardizes, updates, and maintains all training documents and materials. Provide EP letters, Client requisitions, and ABN forms as needed and including communication with Customer Systems and Marketing for system needs of client.

4. Coordinates, contacts, and provides all assistance needed to Sales Account Managers / Executives for Client Issues, Education, Training, and communication of billing needs and requirements to ensure reimbursement.

Responds and researches all inquiries from Sales Account Managers / Executives, PSC and IOP Supervisors, and Internal Management regarding any client, patient, policy, reimbursement, or billing process questions.

5. Functions as liaison between Sales Department and External / Internal Departments to convey customer needs and requests.

Recommends and analyzes innovative billing processes to satisfy customer needs while meeting the needs of the business and satisfying all billing requirements.

Tracks and trends all ongoing client errors and communicate any non-compliant or non-receptive responses from External Customers.

6. Establishes positive, proactive relationships. Performs Service & Guidance visits as time allows, New Client Contact, and In-service Training for Clients which includes research specific to Client, providing materials and contact resources, and assuring Quality Customer Service for retaining business and relationship.

Provides feedback and follow up to Clients regarding chronic errors, improvements, and new billing guidelines and policies regularly.

KNOWLEDGE / SKILLS / ABILITIES

Ability to learn SQL billing systems, policies, and procedures.

Excellent communication skills, both verbal and written.

Strong PC and system skills (billing and laboratory) and working experience with Excel, Windows, and database websites and applications.

Good knowledge of medical terminology and / or CPC coding or equivalent.

MINIMUM QUALIFICATIONS

Associates Degree in Business, Medical Billing or Medical Management and three (3) years of Laboratory Billing or Medical Billing Management experience, OR HSD / GED and five (5) years of Laboratory Billing or Medical Billing Management experience.

Ability to travel frequently.

Valid state AZ Driver’s License with Clean DMV record.

PREFERRED QUALIFICATIONS

Additional education and applicable experience.

Last updated : 2024-06-05