Laboratory Billing Specialist

It's more than a career, it's a calling. WI-REMOTE Worker Type: Regular Job Highlights: 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. WORK SCHEDULE Monday - Friday 8-hour shift, 40 hours per week. No on-call requirement. Job Summary: Performs the daily billing and coding for the laboratory. Works to resolve coding and billing issues that prevent timely submission of insurance claims. Ensures the appropriate department charges are applied to patient accounts. Job Responsibilities and Requirements: PRIMARY 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. EDUCATION High School diploma/GED or 10 years of work experience EXPERIENCE Two years' experience PHYSICAL REQUIREMENTS 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. REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS None Department: 3401000007 Lab - General Work Shift: Day Shift (United States of America) Scheduled Weekly Hours: 40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more. Apply To This Job