Laboratory Applications and Billing Specialist

Company: Covenant Management Systems, L.P.
Location: Austin
Posted on: November 22, 2021

Job Description:

ABOUT AUSTIN REGIONAL CLINIC Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 10 years We are one of central Texas' largest professional medical groups with 25 locations and we are continuing to grow. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance, Development and more. For additional information visit https://www.austinregionalclinic.com/careers/ PURPOSE: Helps monitor and maintain the databases in the lab systems, and ongoing database management. Performs duties necessary for accurate and timely laboratory send-out billing. Carries out all duties while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization. MAJOR RESPONSIBILITIES: Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct. Regular and dependable attendance. Follows the core competencies set forth by the Company, which are available for review on CMSweb. Helps monitor and maintain the databases in lab systems, and ongoing database management. Helps support Laboratory Information Systems (LIS) functions & Database maintenance. Helps process incoming Lab Support inquiries, troubleshooting calls, and/or messages. Helps develop and test rules in laboratory test environments. Helps in the validation of Codemap files that are used to determine Medical necessity for lab tests. Helps maintain and promulgate the routing and billing rules in COPIA. Audits laboratory send out bills (CPL, Lab Corp, TDH, etc.) for accuracy and completeness. Authorizes payment of bills to Accounting department. Answers coding questions for laboratory personnel, business office staff, physicians and nurses. Researches clinical utility and cost of esoteric tests as needed using the internet, literature, and by consulting with Pathologist and/or lab managers. Answers patient calls regarding laboratory billing questions. Assists with updating computer system by informing Coding Quality and IT staff of additions/changes/deletions of test codes and related information (CPT codes, cost, laboratory information, etc.) Identifies opportunities to reduce laboratory send out costs by reviewing Explanation of Benefits (EOB) and suggesting contractual and operational changes to Austin Regional Clinic administration. Helps support Lab Work Queue and assists in Charge entry. Works holiday shift(s) as required by Company policy. OTHER RESPONSIBILITIES: Works with Central Billing and Coding Quality departments in developing, implementing, and monitoring billing edits and clinic work queues. Helps train new laboratory personnel with test ordering, coding, billing, and Advance Beneficiary Notices (ABN.) Stays abreast of health plan changes as they relate to laboratory billing and reimbursement by working closely with CBO. Updates CPL of provider changes and the provider's UPINs and NPIs. Set up doctors and employees in LIS. Assist with interface issues. Assists with special projects as assigned. Travels, as needed, for laboratory hardware assessments and testing. Performs other duties as assigned. QUALIFICATIONS: Required: Bachelor's degree in Clinical Lab Science or related field preferred, or Six (6) years clinical lab experience. Preferred: One (1) year experience working in an ARC laboratory preferred. Experience with EPIC,COPIA, and Harvest preferred. Work Schedule: Monday-Friday, 8:00am-5:00pm

Keywords: Covenant Management Systems, L.P., Austin , Laboratory Applications and Billing Specialist, Accounting, Auditing , Austin, Texas