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

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  Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct.

  
  


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  Regular and dependable attendance.

  
  


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  Follows the core competencies set forth by the Company, which are available for review on ARC Sharepoint.

  
  


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  Helps monitor and maintain the databases in lab systems, and ongoing database management.

  
  


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  Helps support Laboratory Information Systems (LIS) functions & Database maintenance.

  
  


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  Helps process incoming Lab Support inquiries, troubleshooting calls, and/or messages.

  
  


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  Helps develop and test rules in laboratory test environments.

  
  


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  Helps in the validation of Codemap files that are used to determine Medical necessity for lab tests.

  
  


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  Helps maintain and promulgate the routing and billing rules in COPIA.

  
  


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  Audits laboratory send out bills (CPL, Lab Corp, TDH, etc.) for accuracy and completeness.

  
  


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  Authorizes payment of bills to Accounting department.

  
  


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  Answers coding questions for laboratory personnel, business office staff, physicians and nurses.

  
  


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  Researches clinical utility and cost of esoteric tests as needed using the internet, literature, and by consulting with Pathologist and/or lab managers.

  
  


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  Answers patient calls regarding laboratory billing questions.

  
  


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  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.)

  
  


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  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.

  
  


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  Helps support Lab Work Queue and assists in Charge entry.

  
  


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  Works holiday shift(s) as required by Company policy.

  
  

OTHER DUTIES AND RESPONSIBILITIES

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  Works with Central Billing and Coding Quality departments in developing, implementing, and monitoring billing edits and clinic work queues.

  
  


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  Helps train new laboratory personnel with test ordering, coding, billing, and Advance Beneficiary Notices (ABN.)

  
  


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  Stays abreast of health plan changes as they relate to laboratory billing and reimbursement by working closely with CBO.

  
  


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  Updates CPL of provider changes and the provider’s UPINs and NPIs.

  
  


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  Set up doctors and employees in LIS.

  
  


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  Assist with interface issues.

  
  


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  Assists with special projects as assigned.

  
  


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  Travels, as needed, for laboratory hardware assessments and testing.

  
  


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  Performs other duties as assigned.

  
  

QUALIFICATIONS

Education and Experience:

Required:

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  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

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

  
  


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

  
  


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  Excellent computer and keyboarding skills, including familiarity with Windows.

  
  


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  Excellent verbal and written communication skills.

  
  


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  Ability to manage competing priorities.

  
  


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  Ability to perform job duties in a professional manner at all times.

  
  


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  Ability to understand, recall, and communicate, factual information.

  
  


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  Ability to understand, recall, and apply oral and/or written instructions or other information.

  
  


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  Ability to organize thoughts and ideas into understandable terminology.

  
  


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  Ability to apply common sense in performing job.

  
  


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  Knowledge of laboratory billing practices and related coding.

  
  


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  Excellent customer service skills.

  
  


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  Ability to work in a team environment.

  
  


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  Ability to handle competing priorities.

  
  


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  Excellent interpersonal & problem solving skills.

  
  

Certificate/License

None.

Work Schedule: Monday through Friday, 9am-6pm, rotating on-call weekends