Provides charge entry, insurance expertise, registration, and customer service to support the laboratory department and patient/client revenue cycle for hospital and outreach accounts.
- Maintains functional knowledge of charge entry, CPT, ICD-10 changes, coding practices, and insurance terminology.
- Enters daily department charges, credit, or add charges.
- Monitors reports and work queues for appropriate charging, coding/modifiers, charge transfers, charge corrections, reconciliation, delinquent report follow-up, and issue resolution.
- Verifies diagnosis codes and corresponding laboratory tests meet medical necessity criteria to help ensure claims are paid on first submission.
- Works with ordering personnel, including physician office staff, to resolve discrepancies and provide education.
- Updates patient registrations as needed using hospital and laboratory policies and procedures.
- Keeps current on insurance carrier rules and changes through education opportunities and email notifications.
- Meets charge posting deadlines and resolves accounts pending review, additional information, or correction.
- Uses EPIC and XIFIN to manage work queues supporting timely claims processing and client/patient billing.
- Assists with development and maintenance of departmental policies and procedures.
- Serves as a resource for billing system functionality and helps resolve billing questions and concerns.
- Answers client calls regarding billing, pricing, and CPT codes in a courteous and clear manner.
- Provides recommendations to optimize revenue.
- Serves as a resource to laboratory staff and customers.
- Participates in meetings and committees as assigned.
- Maintains compliance with applicable federal, state, and local laws and regulations, as well as organizational integrity and standards of conduct.
Requirements & Qualifications
- High school diploma or GED required.
- One year of experience with healthcare billing and coding preferred; accounts receivable or banking experience also considered.
- Associate degree or bachelor's degree preferred.
- Laboratory billing experience preferred.
- Basic knowledge of third-party payor, insurance, and regulatory requirements preferred.
- Working knowledge of computer information systems with the ability to use several applications concurrently.
Location
Des Moines, Iowa, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 week ago
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