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Pathology Billing Specialist - FT; Days (6696)

Children's Hospital & Medical Center - Omaha Omaha, NE
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Job Description

Just like the patients we serve, Children's is growing quickly and hiring a Pathology Billing Specialist to perform a variety of tasks related to billing for pathology services including coding and charge verification and review. Collect and verify information for the purpose of billing fees for services while ensuring compliance with regulatory requirements. Perform claim submission activities, including verifying existing information is accurate, determining when additional data is needed and collecting necessary details to ensure claim is complete. Serve as a resource and provides support for billing and claim compliance issues within Pathology.  Assist with research and identification of high volume and high dollar tests for optimization of reference labs cost savings.  Analyze effectiveness of billing process; making recommendations to increase efficiency.

Essential Functions/Competencies

% of Time

 

85%

  • Reviews and verifies assigned codes and billing information according to regulations and accurate clinical information to obtain the most specific healthcare information. Gathers encounter information from a variety of sources for the purpose of billing pathology fees
  • Contacts reference labs when needed for clarification of clinical information as appropriate
  • Maintains up-to-date knowledge of regulatory requirements to accurately validate and reconcile codes for appropriate reimbursement of healthcare services
  • Perform manual charge entry by gathering healthcare encounter information from a variety of sources in order to accurately bill charges for services performed from reference labs that  have not been interfaced to EPIC
  • Works with CDM to determine final pricing based on charge from reference lab
  • Works with LIS (EPIC)  team to ensure build is accurate for tests
  • Utilize knowledge to determine tests that can be performed by other reference labs to reduce costs without jeopardizing the integrity of the results
  • Works with management  to promote the use of new reference labs or bringing tests in house for cost efficiency
  • Compare methodologies by reviewing reporting format and understanding clinical needs for the most cost effective test based on clinical need
  • Utilize multiple information systems to accurately select the correct patient account in order to appropriately review and verify patient billable charges
  • Participate in and assist with audits to capture lost charges and determine the accuracy of billing as necessary
  • Ensure information entered in the system is done in an accurate and timely manner.  Verifying charges on accounts as needed
  • When necessary, work with Access to create a registration in the appropriate system (EPIC) from documentation provided to accurately record encounter

10%

  1. Responds to inquires from provider offices and various internal departments in a timely and accurate professional manner.
  • Demonstrate and support good relations between Children’s Hospital, the contracted providers, and the community
  • Make inquires to others on the accuracy of the information, as needed.  Follow- up on pending requests when necessary

 

Regular attendance at work is an essential function of the job.

 

Perform physical requirements as described in the Physical Requirements section

SECONDARY FUNCTIONS/COMPETENCIES

5%

  1. Performs other duties as assigned

100%

 

KNOWLEDGE, SKILLS AND ABILITIES:

  • Knowledge of Lab and  pediatric tests requested by stakeholders
  • Ability to pay attention to detail
  • Ability to provide a pleasant and welcoming appearance to all with which you come in contact
  • Ability to read, write, type, and follow oral and written directions
  • Ability to work independently to effectively and efficiently perform assigned duties.

 

EDUCATION AND EXPERIENCE:
  • Associate’s degree from an accredited college or university in Medical Laboratory or related science required

 

CERTIFICATIONS/LICENSURE REQUIREMENTS:

  • Current and valid Medical Laboratory Scientist certification with the American Society of Clinical Pathology or other equivalent certifying agency required within 6 months of hire

 

Ind123    glassdoor

 

Job Details

Date Posted November 2, 2018
Date Closes January 31, 2019
Requisition 929610-13369
Address 8200 Dodge Street
Located In Omaha, NE
Job Type Full-time Employee
Compensation Hourly Wage, Based on Experience
Shift
Daytime
Mon: 8 am to 4 pm
Tue: 8 am to 4 pm
Wed: 8 am to 4 pm
Thu: 8 am to 4 pm
Fri: 8 am to 4 pm
Hours 40 hours per week
SOC Category 43-6013.00 Medical Secretaries
Zipcode 68114

This job offers the following benefits

  • 403(b) Retirement Savings Plan
  • Dependent-Care Spending Accounts
  • Flexible Spending Accounts
  • Health-Care Spending Accounts
  • Accidental Death and Dismemberment
  • Business Travel Accident Insurance
  • Dental
  • Dependent Life Insurance
  • Employee Assistance Program (EAP)
  • Group Homeowners and Auto
  • Group Legal
  • Life Insurance
  • Long-Term Disability
  • Maternity / Paternity / Family Leave
  • Medical
  • Prescription Drug Plan
  • Short-Term Disability
  • Supplemental Insurance
  • Vision
  • Voluntary Life Insurance
  • Bereavement Pay
  • Cafeteria / Food
  • Continuing Education Program
  • Credit Union
  • Discounts on Employer Merchandise & Services
  • Employee Referral Program
  • Financial Planning
  • Free Parking
  • Health Fair
  • Nursing Facilities
  • Paid Holidays
  • Paid Vacations
  • Tuition Reimbursement
  • Wellness Program
  • Workout Facilities
  • Achievement Awards
  • Bonus Plan
  • Merit Increases

This job requires the following skills

  • Clerical
  • Computer Usage
  • Excellent Communications
  • Excellent Team Member
  • Positive Attitude
  • Medical Billing
At a Glance
Enjoy these benefits
  • 403(b) Retirement Savings Plan
  • Dependent-Care Spending Accounts
  • Flexible Spending Accounts
  • Health-Care Spending Accounts
  • Accidental Death and Dismemberment
  • And More ...
Location