Billing Specialist

The Billing Specialist is responsible for managing assigned aspects of laboratory billing and accounts receivable. This includes accurately reviewing and reporting on billing information, ensuring compliance with regulatory standards, handling patient insurance inquiries, and resolving billing discrepancies to optimize revenue cycles.

Key Responsibilities:

• Billing and Coding:
  • Utilize correct coding for laboratory procedures and services in compliance with current coding standards (e.g., CPT, ICD-10, HCPCS).
  • Communicate with accounts/providers/sales team when ICD-10 codes are needed or updates are required.
• Claims Management:
  • Monitor and follow up on unpaid or denied claims.
  • Resolve billing discrepancies and insurance claim rejections.
  • Assist billing company with appeals for denied claims as necessary.
• Accounts Receivable:
  • Maintain and apply knowledge of laboratory billing system to review records of all billing transactions and payments received.
  • Communicate with laboratory billing company to ensure timely collection of outstanding balances.
• Customer Service:
  • Coordinate with laboratory billing company to handle patient and insurance inquiries regarding billing issues.
  • Provide clear and professional communication to resolve billing concerns.
  • Assist Client Relations as needed.
  • Coordinate with Client Relations on account billing tasks.
• Compliance and Reporting:
  • Ensure all billing activities comply with federal, state, and local regulations, as well as company policies.
  • Prepare and submit regular reports on billing activities, revenue cycle performance, and outstanding accounts.
  • Assist the billing team with audits and payment reviews,
• Collaboration:
  • Work closely with laboratory staff, billing company, credentialing company, and other healthcare providers to ensure accurate and efficient billing.
  • Collaborate with the finance department to support month-end and year-end closing processes.