Laboratory Billing Specialist

SSM Health • WI-REMOTE, WI

4d • Remote

About The Position

This is a full time Lab Billing Specialist position for St. Mary's Hospital in Madison working a total of 40 hours per week. Ideal candidates will have clinical laboratory experience with a strong attention to detail and the ability to work independently.

Requirements

• High School diploma/GED or 10 years of work experience
• Two years' experience
• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
• Frequent use of hearing and speech to share information through oral communication.
• Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry.
• Occasional bending, stooping, kneeling, squatting, twisting and gripping.
• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
• Rare climbing.

Nice To Haves

• clinical laboratory experience with a strong attention to detail and the ability to work independently.

Responsibilities

• Manages daily assignments in the hospital information system's work queue for laboratory billing ensuring appropriate registration, CPT/HCPCS code modifiers and appropriate cost centers.
• Performs laboratory billing edits, reviews billing and coding compliance, and reconciliation of billing discrepancies.
• Calculates and manually enters charges for miscellaneous tests and zero-dollar CPT codes.
• Collaborates with revenue integrity to resolve billing and coding discrepancies to comply with timely filling requirements.
• Identifies unusual billing issues or trends and communicates with the responsible party to achieve resolution.
• Works with clinical, financial, IHT, leadership and staff to ensure that coding, charging, reporting and reconciliation processes run appropriately.
• Evaluates customers’ questions and concerns, provides education, reconciles discrepancies and/or escalates to leadership.
• Develops and recognizes strategies for quality improvement opportunities, proposes appropriate solutions, and works jointly to standardize processes.
• Submits requests for lab charging, price calculation, and fee schedule adjustments through the Charge Master request process.
• Maintains knowledge of current Centers for Medicare and Medicaid Services (CMS) guidelines, coding and billing updates, regulatory compliance, documentation requirements, payer policies and laboratory billing practices.
• Performs other duties as assigned.

Benefits

• one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
• instant access to their earned, unpaid base pay (fees may apply) before payday.
• upfront tuition coverage through FlexPath Funded for eligible team members.

What This Job Offers

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