Revenue and Billing Specialist- Policy Compliance
Responsibilities:
Analyzes and maintains billing databases for Medicare and third-party carriers. Reviews the billing process and ensure that automated billing systems provide accurate data in compliance with guidelines. Reviews bulletins, summarize billing data, and notifies billing managers of accuracy of information. Makes ad hoc queries into billing system to locate potential billing rejections and system errors. Designs billing templates for information services. Receives batches of electronic claims, process claims, and sends to respective payers.
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Locates specimen detail, determine appropriate path, and then formats detail in line with systematic billing process and per payer guidelines to generate:
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Offlines, MSP Process
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Provides timely and accurate support for RCM Compliance process (self) audits
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Determines records needed based on request
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Reviews records to locate specific scenarios and that the billing system provided accurate data in compliance with mandated guidelines
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Reviews records to identify differences based on audit request
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Locates and prepares documentation supportive of requests received by RCM Compliance from non-RCM auditors
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Validation of Advanced Beneficiary Notices (ABN) for Medicare
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Reviews and determines validity of ABN received based multiple elements on page, including some subjectivity
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Based on inventory source and review determination makes appropriate system updates to allow for specimen billing
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ABN documented; modifier added/removed
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Document decision with appropriate and detained audit trail notes
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Maintains Medicare Travel Fee Billing:
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Receipt, review, and maintenance of travel log forms
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Identifying errant trends in logs and alerting for site/division notification
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Ensuring retention of log forms for future audit needs
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Maintains system updates to policy data stores in time with requests from Policy Analysts
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LMNI/M, ANTRIM, BAPM, RIDR, Phoenix
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Performs daily duties with limited supervisory interaction
Qualifications:
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High School diploma or equivalent required
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Minimum 2+ years prior medical/healthcare billing experience required
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RCM Billing experience in Denial Operations or Patient or Client, strongly preferred
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CICS Billing System or m-Power knowledge, preferred
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Working Turnstyle skills, preferred
Other desired skills:
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Proficient in alpha/numeric typing and 10-key
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Basic skill proficiency in Excel and Word
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Concise and professional verbal communication skills to interact with team members and management,
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Detail oriented with good organizational skills
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Ability to multitask within multiple systems
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Adaptable with changing duties, following an SOP but able to problem solve and deviate as required by specific requests
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Ability to manage time and tasks independently while working under minimal supervision
Application Window closes: 11-22-24
Hours 8am to 5pm EST
Pay Range: $15.50- $17.50 hr ("or State/Local minimum wage, if higher" )
All job offers will be based on a candidate’s skills and prior relevant experience, applicable degrees/certifications, as well as internal equity and market data.
Benefits: Employees regularly scheduled to work 20 or more hours per week are eligible for comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan. Casual, PRN & Part Time employees regularly scheduled to work less than 20 hours are eligible to participate in the 401(k) Plan only. For more detailed information, please click here.
Labcorp is proud to be an Equal Opportunity Employer:
As an EOE/AA employer, Labcorp strives for diversity and inclusion in the workforce and does not tolerate harassment or discrimination of any kind. We make employment decisions based on the needs of our business and the qualifications of the individual and do not discriminate based upon race, religion, color, national origin, gender (including pregnancy or other medical conditions/needs), family or parental status, marital, civil union or domestic partnership status, sexual orientation, gender identity, gender expression, personal appearance, age, veteran status, disability, genetic information, or any other legally protected characteristic.
We encourage all to apply
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