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Laboratory Billing Specialist
SSM HealthLab Billing Specialist handling daily billing and coding for laboratory at St. Mary's Hospital.
About the role
Key responsibilities & impact- 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.
Requirements
What you’ll need- 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.
Benefits
Comp & perks- 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.
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
laboratory billingCPT codesHCPCS codesbilling compliancereconciliationcharge calculationfee schedule adjustmentsdata entrybilling discrepanciesquality improvement
Soft Skills
collaborationcommunicationproblem-solvingcustomer serviceeducationleadershipstrategic thinkingattention to detailadaptabilityinterpersonal skills