What are the responsibilities and job description for the Laboratory Revenue Cycle Specialist - Laboratory - University Hospital position at USA Health?
USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community.
USA Health is changing how medical care, education and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists and researchers provide the region's most advanced medicine at multiple facilities, campuses, clinics and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall wellbeing of our community.
Responsibilities
The Laboratory Revenue Cycle Liaison reviews charges and coding specific to Lab billing systems for completion of claim submissions; responsible for lab system reviews of specific revenue capture and auditing of billing interface with 3rd party billing company for reference lab services and procedures for USA Health; serves as a communication link between lab staff, physicians, 3rd party billing company, d USA Health team members in discussing issues recommendations, solutions, and answering questions related to patient charges, auditing, and claims billing for the lab; works closely with the manager, staff, IT and hospital departments to ensure accurate provider maintenance and diagnosis coding for lab claims and that quality standards are met within the department; works to educate the staff regarding claims billing issues revenue management and may need to notify IT, management, and staff members of omissions and or corrections and secure those corrections as needed; reviews and audits patient billing from the previous day’s entry and adjusting when necessary within the appropriate time frame within the lab system and 3rd party billing systems; participates in interdepartmental meetings to remove write-off issues; maintains knowledge of Atlan, Apollo, 3rd party billing program for recommendations for managers; maintains and revises the unit’s charge master or proper coding, pricing, and structure; uses CPT, ICD, and HCPCS coding guidelines to validate and/or enter correct codes for 3rd party billing interfaces; conducts daily charge reconciliation between LIS and other systems to ensure appropriate billing; reviews and monitors web information regarding emergency services, reimbursement, and revenue management; assists providers with billing questions and provides feedback; works with Charge Services to address out of bounds or other charging issues which may arise; works with 3rd party billing company to review and address claim denials; provides financial report and analysis to Lab Director to assist in process improvements, increase reimbursement, and lab profitability; participates on committees as assigned; participates in Performance Improvement activities through quality measurement or participation of ICARE process as assigned; regular and prompt attendance; ability to work schedule as defined and overtime as required; related duties as required.
Qualifications
High school diploma or equivalent and four years of medical billing, medical coding, or directly related Electronic Health Record (EHR) experience. CPT, ICD and HCPCS coding is highly preferred. Higher education or CPC certification may substitute one a year-for-year basis for the required experience.
Equal Employment Opportunity/Affirmative Action Employer
USA Health is an EO/AA employer and does not discriminate on the basis of race, color, national origin, sex, pregnancy, sexual orientation, gender identity, gender expression, religion, age, genetic information, disability, protected veteran status or any other applicable legally-protected basis.
