Lab Medical Claims Biller - Houston TX
Lab Medical Claims Biller - Houston TX
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
*This fulltime position is a hybrid role that requires working in the office on Tuesdays and Thursdays at 1200 Binz St Suite 1490 Houston TX 77004. Mon Wed and Fri are typically work from home but may be in office on occasion.*
We seek a highly organized Ancillary AR Manager (medical claims biller) with years of experience in the healthcare industry specifically laboratory medicine. Under the direction of the Manager of Revenue Optimization & Training the Ancillary AR Manager is responsible for ensuring the accurate and timely processing of all claims for our Lab Ancillary. This role includes promptly addressing daily correspondence from physician practices reviewing and appealing insurance claim denials and following up on aged claims. The Ancillary AR Manager will review monthly and weekly accounts receivable dashboards with a strong focus on identifying opportunities for improvement and developing a plan to implement necessary changes to meet performance expectations.
Primary Job Duties:
- Manage the accounts receivable (AR) including analysis of the aged AR identifying root cause issues and suggesting billing rules/edits when appropriate to prevent errors and mitigate insurance denials.
- Maintain current knowledge of payer regulations including ICD10 and CPT codes.
- Analyze billing metrics to report on performance impacts and identify opportunities for improvement.
- Responsible for organizing and leading projects and presenting in front of groups
- Denial management investigate denial sources resolve and appeal denials which may include contacting payer representatives
- Drive toward achievement of departments daily and monthly Key Performance Indicators (KPIs)
- Maintain Clinical Decision Support ( CDS ) Tool for Lab Orders
- Must comply with HIPAA rules and regulations
- Perform other duties and special projects as assigned
Qualifications :
- High School Graduate
- Experience in laboratory billing billing software EDI enrollment and payer portals required
- 5 years experience in a medical billing office or equivalent claims experience
- Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims
- Advanced Microsoft Excel skills (ex: pivot tables VLOOKUP sort/filtering formulas) preferred
- Experience with athenaHeath and/or athenaOne preferred
- Experience with Trizetto and/or Microstrategy preferred
- Expert at managing multiple priorities effectively and efficiently
- The ability to effectively work with other departments to resolve problems. Must have interpersonal skills to gain cooperation with other departments and foster continuous improvements.
- Critical thinking skills to make independent decisions regarding claims adjustments resubmissions appeals and other claim resolution techniques
The salary range for this role is $55000 to $60000 in base pay and exclusive of any bonus or benefits (medical dental vision life and pet insurance 401K paid time off and other wellness programs). This role is also eligible for an annual bonus targeted at 10% based on performance in the role. The base pay offered will be determined based on relevant factors such as experience education and geographic location.
Additional Information :
All your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only not applicable for onsite/in office work):
In order to successfully work remotely supporting our patients and providers we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age color national origin physical or mental (dis)ability race religion gender sex gender identity and/or expression marital status veteran status or any other characteristic protected by federal state or local law.
Remote Work :
No
Employment Type :
Fulltime
Employment Type
Full-time
