Laboratory Billing Specialist - Lab Admin

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

Responsible for ensuring that laboratory billing – to outside payors, third party clients and internal customers - is completed in a timely manner and to ensure that payment(s) are timely and appropriately posted. Under the general direction of the Supervisor or Business Operations Manager, the Laboratory Billing Specialist is responsible for billing all laboratory technical and professional billing through the hospital and professional organization billing offices. Primary responsibilities include communicating with management, physicians, and staff to develop and maintain processes that ensure timely submission of accurate charges. Serves as a liaison with Patient Accounts for hospital and professional billing issues. Provides assistance for patients with billing inquiries. Generates reports and recommends workflow changes to address opportunities for improvement in reimbursement and the patient experience. Ensures compliance with Tufts Medical Centers standard operating procedures pertaining to the Laboratories, and under general direction of the CLIA Laboratory Medical Director (Medical Director), ensures the compliance with applicable federal and state laws and regulations and accrediting agency standards as they may pertain to billing and collections.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Develops and implements processes to ensure that charges are accurate, complete and submitted in a timely manner.
• Responsible for any special billing (e.g. special accounts, offsite billing, research related billing).
• Monitors and provides recommendations to improve controllable losses (such as TES edits, denial reports, queries for back-up documentation). Develops reports for management trending.
• Revises and updates billing forms for hospital and professional billing and ensures correct hospital charge codes. Requests new charge codes as needed.
• Informs staff of any applicable new or revised policies and procedures related to billing and other front-end revenue cycle processes. Provides training and serves as a resource for staff and physicians regarding billing related questions
• Assists with compliance audits
• May assist patients with billing questions and issues; works with patient accounts personnel to resolve issues
• Performs tasks core to the Practice Billing Coordinator role
• Performs other similar and related duties as required or directed
• Demonstrated knowledge of medical terminology; CPT and ICD-10 coding; hospital and professional billing practices
• Analytics and mathematics ability.
• Computer literacy required, including familiarity with email, Microsoft Office programs and scheduling applications.
• Ability to learn and use Tufts network programs required.
• Excellent communications skills, both oral and written.
• Strong organizational and negotiating skills.
• Excellent interpersonal skills required to work with support staff and interact effectively with patients, physicians, various billing personnel, insurance representatives, etc.
• High degree of courtesy and tact required in contacts with patients involving sensitive and confidential patient information.
• Works closely and collaboratively with peers in Finance and the PO.
• High level of professionalism and attention to detail

JOB KNOWLEDGE AND SKILLS:

• Knowledge of CPT and ICD10 coding
• Thorough knowledge of laboratory related compliance standards, regulatory affairs and CAP/TJC accreditation standards.
• Computer skills

EDUCATION:

• Bachelor degree preferred. Associates degree a consideration
• Completed RHIT or CCS certifications

EXPERIENCE:

• Minimum of 3 to 5 years experience in clinical and anatomic laboratory coding, billing and collections.
• An equivalent combination of education and experience which provides proficiency in the areas of responsibility listed above may be substituted for the above education and experience requirements.

LICENSES, ETC.:

• Not Applicable

AGE SPECIFIC COMPETENCIES:

• Not Applicable

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. New England Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

All your information will be kept confidential according to EEO guidelines.