Laboratory Billing Specialist

Position Summary

Quality Forensic Toxicology (QFT) is seeking an organized and detail-oriented Certified Laboratory Medical Billing Specialist to support our internal billing operations and work closely with our third-party billing partners.

This position supports both client invoicing and insurance revenue-cycle activities, helping ensure accurate billing information, complete documentation, timely claim follow-up, and appropriate reimbursement.

The ideal candidate has at least two years of medical billing experience and a strong understanding of insurance verification, claims processing, denials, appeals, and reimbursement. Experience in laboratory, pathology, or other healthcare billing is strongly preferred.

In-House Billing Responsibilities

• Prepare monthly client and project invoices by extracting billing information from the laboratory information system (LIS) and/or Excel reports.
• Apply the appropriate billing rates for each test or service.
• Create and issue client invoices.
• Manage outstanding in-house accounts receivable by sending statements, following up on unpaid invoices, and assisting with collection efforts.
• Accurately record and apply client payments once received.
• Maintain complete and accurate billing records and supporting documentation.
• Prepare end-of-month reports for in-house billing revenue.
• Prepare weekly and monthly case-volume reports.
• Identify billing discrepancies and work with internal departments to resolve issues.

Third-Party Billing & Revenue Cycle Coordination

• Serve as QFT's primary internal point of contact for third-party billing companies.
• Work closely with billing partners to ensure complete and accurate information is submitted to insurance carriers.
• Review and verify patient insurance information and ensure accurate entry into the LIS.
• Review CPT codes assigned to cases for accuracy and escalate discrepancies as needed.
• Complete verification of benefits and review coverage information through payer portals when necessary.
• Monitor billing portals and identify claims or billing issues requiring additional information or documentation.
• Track outstanding claims, denials, and billing issues through resolution.
• Follow up with third-party billing partners regarding unresolved claims, denials, and reimbursement issues.
• Review denied or rejected claims to determine whether additional information or documentation may support resubmission or appeal.
• Coordinate with physician offices, internal staff, and billing partners to obtain medical records, insurance information, orders, and other documentation needed to support claim payment or appeals.
• Assist with payer requests for medical records and other supporting documentation.
• Help identify recurring billing, documentation, or ordering issues that may contribute to denials or delayed reimbursement.
• Assist management with monitoring billing performance, reimbursement trends, and outstanding issues.
• Help improve billing accuracy, claim resolution, and overall reimbursement outcomes.

Required Qualifications

• Minimum of two years of medical billing experience required; five years preferred.
• Strong knowledge of insurance verification, benefits, claims processing, denials, appeals, and reimbursement workflows.
• Experience reviewing and following up on outstanding insurance claims.
• Strong attention to detail and the ability to identify errors, missing information, and documentation deficiencies.
• Excellent organizational, communication, and follow-up skills.
• Ability to manage multiple priorities and outstanding issues in a fast-paced environment.
• Proficiency with Microsoft Excel, Word, and Outlook.
• Ability to work effectively with third-party billing companies, insurance carriers, physician offices, and internal staff.
• Working knowledge of HIPAA and patient privacy requirements.

Preferred Experience

• Certified Medical Biller or other recognized medical billing or coding certification.
• Knowledge of ICD-10 and CPT coding.
• Previous pathology or clinical laboratory billing experience.
• Experience working with Medicare, Medicaid, and commercial insurance carriers.
• Experience working with third-party billing or revenue-cycle management companies.
• Experience with claim denials, appeals, insurance follow-up, and accounts receivable.
• Familiarity with healthcare billing documentation requirements and lab workflows.

Pay: $20.00 - $25.00 per hour

Expected hours: 40.0 – 45.0 per week

Benefits:

• Dental insurance
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $20 - $25