What are the responsibilities and job description for the Medical Billing Manager position at DLS Laboratory?
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