Responsible for monitoring billing processes and makes corrections as needed. Manages the timely and accurate posting of charge data for both patient and client-billed accounts. Identifies, corrects, and maintains appropriate billing data within the information system. Handles customer billing inquiries. Serves as a resource for billing and compliance activities.

The specialist displays a commitment to customer service while completing assignments and engaging with customers in a polite, attentive, and conscientious manner and responds thoughtfully to inquiries regarding specimen collection and handling, laboratory intake processes, and test results. Furthermore, the specialist offers advanced troubleshooting and resolution support for laboratory customers, ensuring their needs are met effectively.

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Responsible for monitoring billing processes and makes corrections as needed. Manages the timely and accurate posting of charge data for both patient and client-billed accounts. Identifies, corrects, and maintains appropriate billing data within the information system. Handles customer billing inquiries. Serves as a resource for billing and compliance activities. The specialist displays a commitment to customer service while completing assignments and engaging with customers in a polite, attentive, and conscientious manner and responds thoughtfully to inquiries regarding specimen collection and handling, laboratory intake processes, and test results. Furthermore, the specialist offers advanced troubleshooting and resolution support for laboratory customers, ensuring their needs are met effectively.

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EDUCATION: High school diploma required. Healthcare certification for MLT/CT is preferred.

YEARS OF EXPERIENCE: One year of laboratory experience required. Previous Customer Service and phlebotomy experience preferred.

REQUIRED SKILLS AND KNOWLEDGE: Excellent customer service skills including superior communication skills (verbal, written, and listening) are required. Good analytical and problem-solving skills are required. Basic knowledge of medical billing – ICD9 Codes and CPT codes. The ability to multi-task effectively in a stressful environment is required.

LICENSES & CERTIFICATIONS:

Certified Medical Laboratory Scientist (MLS) or Medical Laboratory Technician (MLT) or certification through other national certifying agency preferred.

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Customer Focus

• Builds a positive relationship with customers through phone interactions.
• Assists clients and coordinates with technical departments respectfully to ensure quality service delivery.
• Uses proper telephone etiquette when receiving and transferring calls.
• When taking messages, gathers all necessary details such as the caller's name, date, time, and phone number to ensure the accuracy of the situation.
• Asks clarifying questions to identify the underlying problems and offer solutions.
• Advocates for customers by engaging with them positively. Refers to other resources when necessary.
• Uses appropriate laboratory terminology when engaging with the customers.
• Accurately provides test results to the appropriate personnel.
• Adheres to policies regarding the communication of verbal results.
• Follows guidelines for faxing test results.
• Utilizes established protocols and independent judgment to assess the credibility and accuracy of test results.
• Recognizes and addresses any abnormal or unusual patient results, investigates inconsistent findings, and communicates significant patient data or results to the relevant individuals.
• Evaluates and identifies the necessary specifications for specimen collection, ensuring clarity on the type, quantity, and handling procedures to support accurate and reliable testing outcomes.
• Maintains excellent customer service and a 95% answer/call ratio.

Billing

• Edits existing claims, add modifiers, reverse charges, and manages CPT/ICD10 codes.
• Resubmits claims and credit testing when indicated.
• Audits testing to ensure correct billing charges.

Technical

• Efficiently secures and processes written orders, ensuring all documentation is thorough and accurate.
• Prioritizes stat add-ons with a sense of urgency, recognizing their critical role in prompt decision-making.
• Verifies any orders that present uncertainties, ensuring clarity and adherence to established protocols.
• Maintains the integrity of specimens meant for testing, conducting a detailed assessment before accepting requests to guarantee the highest quality of results.

Department Support

• Serves as the on-site technical resource for specimen collection and processing.
• Collects and records all information needed to investigate issues, such as patient details, dates, and tests ordered. Lets customers know when they can expect a follow-up call.
• Takes all necessary steps to fix technical issues and ensure timely solutions. Shows strong knowledge of instruments, quality control, and patient testing.
• Provides on-site technical assistance to data entry staff to assist with handling of samples.
• Documents customer concerns and understands courier schedules/routes.
• Trains staff in bone marrow collections and processing when assigned.
• Reconciles daily logs and troubleshoot sample issues.
• Monitors order statuses and ensures timely finalization of results.
• Resolves issues with test requests and comprehends complex laboratory orders or regulations.
• Assists clients with venipuncture protocols.
• Processes transplant specimens and conducts complex fluid testing.
• Prepares and sends specialty testing samples using external transportation services.

Process Improvements

• Brings to the attention of the management team any recurring challenges and concerns.
• Suggests solutions to issues and aids as needed to implement those solutions within the department.
• Collaborates with lab managers to implement technical changes needed to resolve the issue. Utilizes additional communication methods as necessary.
• Anticipates and actively identifies areas for process and system improvement.

Professional Development

• Maintains currency in the field, including maintenance of any necessary licensure/certification, through continuing education, conferences, meetings, in-services, networking, literature, and/or seminars.
• Performs other duties assigned.