DRG Validation Auditor
AAPC
Unity
Billing Analyst, Lab Outreach
Wellstar Health System
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteJob Level
JuniorMid-Level
Tech Stack
Unity
About the role
- Responsible for ensuring accounts are reviewed, corrected and documented for outreach clients, private insurance, Medicare/Medicaid.
- Timely resolution and tracking of laboratory billing & coding error edits to ensure compliance.
- Account follow-up with clients, physicians and patients to resolve questionable accounts.
- Collaborate with Revenue Cycle, Patient Financial Services, and Accounting to assure proper payment posting and medical assistance eligibility.
- Work assigned work queues to resolve Laboratory Outreach billing and coding errors and investigate insurance plan edits in Epic.
- Monitor and edit CPT codes associated with laboratory tests; monitor lab billing claim holds and investigate incorrect address problems.
- Utilize Health Logic for missing remit/research for Lab Outreach claims and review Client Bill (CIB) and SP3 (TOSP) accounts for accurate adjustments.
- Coordinate credit balance and end-of-month reporting with Accounting; assist with test pricing inquiries and special reporting projects.
- Consistently meet productivity and quality standards and participate in software testing and field integrity verification.
Requirements
- High school diploma or equivalent.
- Billing and Coding Certification upon hire.
- Minimum 2 years experience in health office environment.
- Knowledge of Medical billing and ICD-10 Coding.
- Patient account follow-up and resolution experience.
- Payment posting functions experience.
- Ability to communicate effectively while maintaining confidential and sensitive information.
- Establish and maintain working relationships.
- Efficient organization and time management; ability to be self-directed.
- Decision making and resourceful problem solving; ability to multitask.
- Experience with database management information with insurance coverage.
- Knowledge of medical terminology and abbreviations.
