Billing Representative Specialist

Physicians Laboratory Services is seeking a full-time billing representative who will be responsible for the coordination and facilitation of all Third Party Insurance claims submissions, account refunds, complex adjustments and collections in the Billing Department.  This person will also be responsible for posting denials and non-payment Explanation of Benefits.  This person must be able to process a large number of transactions daily while following all compliance and Medicare/Medicaid regulations as directed.  This position requires excellent telephone communication skills and the ability to maintain positive relationships with clients, patients and payors throughout the billing process. This person must be a detail-oriented problem-solver with good time-management skills and have the ability to work independently or as part of a team.  Previous experience handling clinical and anatomic laboratory charges is preferred.

QUALIFICATIONS:

• High school graduate or equivalent.
• One to two or more years experience in Medical Claims Processing with proficient knowledge of claims payment laws, HIPAA, medical terminology, CPT and ICD10 coding.
• Medical Coding Certificate preferred, but not required.
• Possess effective communication skills to provide excellent customer service.
• Bilingual in Spanish/English a plus.

ESSENTIAL FUNCTIONS:

• Post both electronic and paper payments ensuring accuracy and speed.
• Review payment denials to determine that procedures were coded accurately and properly rejected by carrier.
• Work with clients to gather additional documentation that may be needed to resolve claim denials.
• Prepare appeals when claims have been improperly submitted or denied.
• Work with patients to accept payments, work out financial arrangements and resolve problems.
• Maintain strict confidentiality according to Laboratory policy.
• Other duties as assigned.

Benefits eligible position.

Physicians Laboratory Services, Inc is an Affirmative Action/EEO Employer - qualified applicants will be considered for employment without regard to protected veteran or disability status, race/color, religion, gender, national origin or any other legally protected basis.