Facility: VIRTUAL-GA

Job Summary:

Lab Outreach Billing Analyst is directly responsible for ensuring all accounts are reviewed, corrected and documented as appropriate monetary remittances to the Wellstar Health System from outreach clients, private insurance payers, and Medicare/ Medicaid. Additionally, this task will be accomplished through the performance of the job related tasks that include but not limited to :(1) timely resolution and tracking of laboratory billing & coding error edits to ensure compliance (2) account follow-up with clients, physicians and patients to assure timely resolution of questionable accounts, and (3) facilitate and work collaboratively with other Wellstar departments {Revenue Cycle department and Patient Financial Services Department, etc.} to assure proper payment posting and medical assistance eligibility.

Core Responsibilities and Essential Functions:

__Laboratory Billing Analyst duties and responsibilities__ __A. Billing and Coding__ 1. Work assigned work queues to resolve Laboratory Outreach billing and coding errors 2. Review insurance entry and account follow-up with other Wellstar Revenue Cycle Departments. 3. Investigate and review insurance plan edits in Epic - patient accounts 4. Monitor the accuracy of and edit as appropriate the CPT codes associated with each laboratory test __B. Account Follow-up responsibilities__ 1. Follow-up with physician and patient clients to ensure proper and timely resolution of questionable accounts. 2. Check and manage work queues as directed by supervisor. 3. Monitor lab billing claim holds 4. Investigate and resolve incorrect address problems. 5. Investigate / review Client Bill- CIB accounts 6 Review SP3 (TOSP) accounts for accurate adjustments. 7. Utilize Health Logic for missing remit/ research for Lab Outreach claims. 8. Assist and work on "special reporting projects" as assigned 1. Consistently meet the current productivity standards in addressing and resolving accounts 10. Consistently meet the current quality standards in taking appropriate actions to identify and track root causes, and trend issues. #### C. Outreach Laboratory Billing Liaison to WellStar Accounting, and Revenue Cycle Dept.__ 1. Work collaboratively performing Lab Outreach service recovery as it relates to all billing issues between Wellstar Revenue Cycle and Accounting Dept. 2. Work assigned work queues to resolve all billing/ coding issues within Epic accounts. 3. Coordinate with Accounting personnel to work 'credit balance and the end of month reporting information. 4. Assist with Lab Outreach test pricing inquiries Teamwork Responsibilities - Provide individual contribution to the overall team effort of achieving the department AR goal. - Identify opportunities for system process improvement and submit in team meetings - Participate and encourage team collaboration and unity - Initiate communication with peers about changes and procedures, convey new relevant information to other team members and management. Administrative Responsibilities - Assure patient privacy and confidentiality as appropriate or required - Follow department guidelines for lunch, breaks, requesting time off, and shift assignments - Utilize assigned computer hardware, and report hardware problems to the appropriate source. - Participate in the testing for the assigned software applications, including verification of field integrity when needed. - Perform other duties and responsibilities as assigned Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

High school diploma or equivalent. Required

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

Additional License(s) and Certification(s):

Billing and Coding Certification Upon Hire Preferred

Required Minimum Experience:

Minimum 2 years experience in health office environment along with basic knowledge of (1) Medical billing and ICD-10 Coding, (2) patient account follow-up and resolution processes, (3) payment posting functions. Required

Required Minimum Skills:

Must be able to communicate effectively while maintaining confidential and sensitive information; Establish and maintain working relationships; Demonstrate efficient organization and time management skills; ability to be self-directed; Decision making and resourceful in problem solving; ability to multitask; Experience with data base management information with insurance coverage, Knowledge of medical terminology and abbreviations.