Laboratory Applications and Billing Specialist

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 EMR and LIS software preferred.

Work Schedule: Monday through Friday, 8:00am-5:00pm as well as occasional on-call duties.