Laboratory Billing Specialist

Overview

This is a full-time Lab Billing Specialist position based in Madison, WI, with remote work options. The role involves working 40 hours per week, Monday through Friday, with no on-call requirements.

Responsibilities

• Manage daily assignments in the hospital information system's work queue for laboratory billing, ensuring appropriate registration, CPT/HCPCS code modifiers, and cost centers.
• Perform laboratory billing edits, review billing and coding compliance, and reconcile billing discrepancies.
• Calculate and manually enter charges for miscellaneous tests and zero-dollar CPT codes.
• Collaborate with revenue integrity teams to resolve billing and coding discrepancies to comply with timely filing requirements.
• Identify unusual billing issues or trends and communicate with responsible parties to achieve resolution.
• Work with clinical, financial, IT, leadership, and staff to ensure coding, charging, reporting, and reconciliation processes run appropriately.
• Evaluate customer questions and concerns, provide education, reconcile discrepancies, and escalate issues to leadership as needed.
• Develop and recognize strategies for quality improvement opportunities, propose solutions, and work jointly to standardize processes.
• Submit requests for lab charging, price calculation, and fee schedule adjustments through the Charge Master request process.
• Maintain knowledge of current Centers for Medicare and Medicaid Services (CMS) guidelines, coding and billing updates, regulatory compliance, documentation requirements, payer policies, and laboratory billing practices.
• Perform other duties as assigned.

Requirements

• High School diploma or GED, or 10 years of work experience.
• Minimum of two years' experience in a related role.

Physical Requirements

• Frequent lifting, carrying, pushing, and pulling of objects weighing 0-25 lbs.
• Frequent sitting, standing, walking, reaching, and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for near (20 inches or less) and far (20 feet or more) distances, including color identification.
• Frequent use of hearing and speech for oral communication and ability to hear alarms or malfunctioning machinery.
• Frequent keyboard use and data entry.
• Occasional bending, stooping, kneeling, squatting, twisting, and gripping.
• Occasional lifting, carrying, pushing, and pulling of objects weighing 25-50 lbs.
• Rare climbing.

Certifications

• No professional licenses or certifications are required.

Compensation & Benefits

• Paid parental leave: eligible team members receive one week of paid parental leave for newborns or newly adopted children (pro-rated based on full-time equivalent).
• Flexible payment options: eligible hourly team members have access to earned, unpaid base pay before payday through a voluntary benefit program (fees may apply).
• Upfront tuition coverage: eligible team members can access upfront tuition coverage through a funded program.

Location

• Position is based in Madison, Wisconsin with remote work options available.
• Work schedule is Monday through Friday, 8-hour day shifts, totaling 40 hours per week.