Lab Billing & Coding Rep + Department: Laboratory - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Information Tech + Employment Type: Full - Time + Job ID: 47164 + Experience Required: 1 - 3 Years + Education Required: HS Diploma/GED + Shift: Day + Location: Remote + Usual Schedule: NA + On Call Requirements: NA + Work Location: Working from Home + Weekend Requirements: NA + Holiday Requirements: NA Email a Friend Save Save Apply Now Position Summary: The Laboratory Billing & Coding Representative is responsible for accurate and timely billing of Laboratory services. Responsible for understanding medical terminology, patient registration, insurance eligibility, payer rules, CPT/HCPCS bundling, CCI modifiers, and lab-related coding for problem resolution. Responsible for understanding and applying compliance and regulatory guidelines to resolve charge review edits, claim edits, billing-related issues, and assigned work queues. Functions as a lab-billing resource for internal and external parties. This position uses Carle electronic medical record systems and Lab Information System to review clinical encounters and laboratory results. Qualifications: EXPERIENCE REQUIREMENTS Three (3) years Healthcare/Medical experienceProficient computer knowledge related to Microsoft Office applications such as Word, Excel, Outlook, and Teams SKILLS AND KNOWLEDGE Knowledge of patient registration, billing processes, medical terminology, and coding applicable to position. Ability to deal with a large volume of work, multitask, easily accept and implement change, and perform computer data entry. Basic/Intermediate Level experience in Microsoft Outlook, Word, Excel, and Teams. Ability to work with others collaboratively, both orally and in writing. Essential Functions: + Experience with Lab Billing and Coding/Preferred + Experience with Epic Registration/Preferred + Responsible for resolving Lab-related CPT, HCPCS, and applicable ICD-10 inquiries for internal and external parties. + Responsible for editing laboratory test charges to ensure CPT/HCPCS codes are appropriate for tests being billed and appropriate modifiers are applied. Ensures all charges are corrected when additional tests are ordered, or tests are cancelled at a later date. + Responsible for researching and resolving assigned billing reports and work queues on a daily basis for registration errors, charge review, claim edits, etc. + Responsible for understanding and applying compliance, regulatory, and CPT/HCPCS bundling rules for Laboratory billing. + Facilitates maximization of revenue by ensuring correct coding initiatives and payer-specific guidelines are applied appropriately. + Works collaboratively with Revenue Cycle, Coding, and other departments to resolve patient or payer-related charge and account inquiries, coding, denials, lab orders, trends, etc. + Reconciles Referred (send-out) Testing invoices, calculates charges, keys billable services into systems, and reports discrepancies to appropriate internal and external parties. + Communicates issues and trends to management to maintain departmental compliance and improve processes. Attends and provides input at meetings and trainings. + Assists with Reference Laboratory billing processes. + Assists with financial and statistical reports. + Ensures quick responses to clients and patients regarding billing concerns. + Ensures daily work assignments are complete by promoting teamwork and good communication. + Assists with audits, special projects, and annual policy and procedure review process as requested. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: human.resources@carle.com. Effective September 20, 2021, the COVID 19 vaccine is required for all new Carle Health team members. Requests for medical or religious exemption will be permitted.