Clinical Laboratory Billing Specialist (RCM) (Hybrid)

NOTE: This opportunity is open to full-time employment (no C2C or 1099 engagements, or third parties, please). The candidate MUST be authorized to work in the United States without sponsorship. local to the greater Macon GA metro area and available to be on-site in this hybrid role

Daily Responsibilities

• Support the billing and reimbursement operations for clinical laboratory services.
• Responsible for accurate claim preparation, coding review, claim submission, and follow-up on payer responses to ensure timely and accurate reimbursement for laboratory testing services.
• Prepare and submit laboratory claims to Medicare, Medicaid, and commercial insurance carriers.
• Review laboratory test orders and documentation to ensure accurate CPT and ICD-10 coding.
• Resolve claim edits and rejections prior to submission.
• Conduct denial management and payer follow-up to secure reimbursement.
• Assist with appeals and documentation submission for denied claims.
• Maintain accurate patient billing records and documentation.
• Work closely with laboratory accessioning and operations teams to correct billing discrepancies.
• Monitor claim status and ageing reports to ensure timely collections.
• Ensure compliance with payer policies and laboratory billing regulations.
• Support audits and compliance reviews when necessary.

• Must be authorized to work in the United States without sponsorship.
• Must be within daily commuting distance to the greater Macon GA metro area to be on-site (hybrid schedule).
• 2 years of experience in healthcare billing or laboratory revenue cycle operations.
• Knowledge of CPT and ICD-10 coding.
• Experience with Medicare and commercial payer billing.
• Strong attention to detail and organizational skills.
• Analytical and problem-solving skills in complex, ambiguous environments.
• Associate or bachelor’s degree in healthcare administration, finance, business, or equivalent experience may be substituted for experience.

Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, location, and other business and organizational needs.