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Medical Billing Manager

DLS Laboratory
Garden, CA Full Time
POSTED ON 3/30/2025
AVAILABLE BEFORE 5/29/2025

Overview:

We are seeking a highly experienced Laboratory Billing Manager to oversee and manage all facets of the billing department for a high-volume diagnostic laboratory. The ideal candidate will have extensive hands-on experience in laboratory billing, including a deep understanding of laboratory-specific coding, payer policies, compliance requirements, and the intricacies of laboratory revenue cycle management. This role requires a strategic, detail-oriented leader who thrives in a fast-paced environment and can drive billing operations from the ground up.

Key Responsibilities:

  • Oversee day-to-day operations of the laboratory billing department, including hiring, onboarding, and training billing staff.
  • Lead the development and implementation of internal billing processes, systems, and team structure tailored to laboratory operations.
  • Manage the complete revenue cycle specific to laboratory services, including timely claim submission, denial management, and collections.
  • Ensure accurate billing and coding for laboratory tests including molecular, toxicology, pathology, and routine diagnostics.
  • Submit claims through multiple clearinghouses and software platforms (EMR, LIS, PM systems); oversee and validate submissions completed by billing specialists.
  • Monitor reports to ensure clean claims and minimize rejections and denials.
  • Identify and resolve payer-specific issues related to lab test billing by working with payers and vendors.
  • Stay current with lab-specific regulations, including Medicare and commercial payer requirements, CPT and HCPCS coding updates, and billing compliance standards.
  • Conduct regular audits of claims to ensure accuracy and compliance with coding, documentation, and regulatory standards.
  • Monitor A/R aging reports, identify payment trends and underpayments, and lead resolution efforts.
  • Develop and maintain standard operating procedures (SOPs) for all aspects of laboratory billing.
  • Provide strategic leadership and continuous process improvement to maximize billing performance and revenue.
  • Generate and present monthly reports on revenue cycle metrics to executive leadership.
  • Collaborate with the Director of Operations and other stakeholders to ensure audit readiness, including Medicare audits.
  • Serve as a mentor and leader for the billing team, fostering a high-performing, accountable, and collaborative work culture.

Qualifications:

  • Must reside in the Greater Orange County area.
  • Minimum of 5 years of laboratory billing experience in an independent lab setting (e.g., toxicology, molecular, pathology).
  • Minimum of 10 years of experience in medical billing.
  • At least 5 years of experience managing billing staff with a proven ability to lead, coach, and drive team performance.
  • Deep understanding of the laboratory revenue cycle, coding (CPT, HCPCS), payer-specific rules, and compliance issues.
  • Familiarity with Laboratory Information Systems (LIS), Practice Management (PM) systems, and EMRs.
  • Proficiency in claim submission, denial resolution, payment posting, and A/R follow-up.
  • Strong knowledge of healthcare regulations, including HIPAA and Medicare billing rules.
  • Excellent communication, problem-solving, and leadership skills.
  • Ability to work independently and collaboratively in a multidisciplinary environment.
  • Experience building billing operations from the ground up is highly desirable.

Compensation & Benefits:

· This is a full-time, on-site position based at our laboratory facility. We offer competitive compensation and a comprehensive benefits package. Salary is dependent on experience (DOE).

Job Type: Full-time

Pay: $30.00 - $40.00 per hour

Benefits:

  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule:

  • 8 hour shift
  • Day shift
  • Monday to Friday

Work Location: In person

Salary : $30 - $40

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