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 15 years!   We are one of central Texas’ largest professional medical groups with 35+ 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.

ESSENTIAL FUNCTIONS

• 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 ARC Sharepoint.

• 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 DUTIES AND 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

Education and Experience:

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.

Knowledge, Skills and Abilities

• Ability to engage others, listen and adapt response to meet others’ needs.

• Ability to align own actions with those of other team members committed to common goals.

• Excellent computer an