Client Services & Lab Billing Support Specialist

American Oncology Network • Fort Myers, FL

2d • $16 - $24 • Onsite

About The Position

Under the general supervision of the Client Services Manager, this role is responsible for reviewing, updating, and maintaining established work standards to maximize productivity within the revenue cycle and Client Services. The specialist may assist in accessioning for clinical and pathology testing, answering incoming calls and emails, and maintaining all 3rd party testing. This position acts as a liaison between the business office, clinic, and lab to ensure all internal and external customer service needs are addressed. Responsibilities include reviewing medical insurance policies, utilizing the Insurance Matrix and Provider Billing Report for proper test routing, and working with the Utilization Management (UM) team to obtain authorizations. The role also involves assisting the revenue cycle in reviewing BI reports and addressing denials and claims resubmissions. Additionally, the specialist will assist with monthly quality assurance reports, maintain a proper communication platform, and assist with accessioning duties such as packing and unpacking specimens, reviewing specimen quality, accessioning in the Lab Information System (LIS), and distributing specimens. Clerical, technical, and administrative tasks to organize and maintain the lab area are also part of the role.

Requirements

• High School Diploma Required
• 1-2 years in a medical billing and/or laboratory environment
• Experience in medical and/or laboratory setting with an understanding of medical/laboratory terminology required.
• 1-2 years’ experience with insurance authorization and benefit investigation required.
• Candidate must demonstrate dependability, flexibility, and adaptability in all aspects of laboratory responsibilities and scheduling hours and have a general understanding of insurance billing if applicable.
• Proficiency in MS Office Word, Excel, Power Point, and Outlook required.

Nice To Haves

• Bachelor’s Degree Preferred
• Students seeking Bachelor of Science Degree in Biology, Chemistry, Molecular Biology, or related field desirable.
• CCA (Certified Coding Associate), CCS (Certified coding Specialist) or CPC certification (Certified Professional Coder) Preferred but not required.
• Second language is an asset but not required.

Responsibilities

• Handles all customer inquiries received by telephone, fax, and email regarding reporting of patient results, inquiries of test and services, concerns of service failures and other duties to provider superior service.
• Report laboratory results to providers using established protocols.
• Document reporting and call history in required format and maintain complete and accurate records.
• Assists in resolving routine matters related to patient testing and result reporting.
• Report client concerns using the established protocols.
• Provides education and updates pertaining to laboratory processes.
• Understands the importance of Quality Service and how it is measured.
• Performs other duties as required to meet the customer requirements.
• Assists with Accessioning as needed and maintains proper training required to perform accessioning tasks.
• Verifies that all executed authorizations and insurance verification have been received, scanned and that documents are maintained in the EMR, and billing database is updated.
• Extract scheduling reports to review routing, auth requirements, and follow up on changes to shipping and ordering.
• Prepares and reviews test routing reports and volumes reports monthly.
• Prepares and reviews denial reports monthly.
• Reviews and maintains inhouse testing menus and clinic contact lists.
• Reviews inhouse and send out cases to ensure TAT meets standard procedures.
• Assists with claims processing to ensure appropriate laboratory reports are uploaded into the EMR.
• Reviews pathology cases for appropriate diagnosis codes and updates accordingly.
• Reviews clinical billing to ensure appropriate diagnosis codes are updated and used according to guidelines.
• Liaison between laboratory, clinic, and reference laboratories to ensure timely claims processing by reviewing problem holds.
• Screen test orders to ensure proper auth is on file and compatible/ proper ICD codes used for processing.
• Submits billing for SPEP and electrophoresis testing and uploads results into ONCO EMR.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED