What are the responsibilities and job description for the Clinical Laboratory Revenue Cycle Specialist position at Labarium?
POSITION SUMMARY
The Clinical Laboratory Revenue Cycle Specialist supports the billing and reimbursement operations for Labarium Diagnostic Systems' clinical laboratory services. This role is responsible for accurate claim preparation, coding review, claim submission, and follow-up on payer responses to ensure timely and accurate reimbursement for all laboratory testing services across Labarium's network.
KEY RESPONSIBILITIES
• Prepare and submit laboratory claims to Medicare, Medicaid, and commercial insurance carriers.
• Review laboratory test orders and supporting documentation to ensure accurate CPT and ICD-10 coding prior to submission.
• Resolve claim edits and rejections prior to submission to reduce denial rates and accelerate reimbursement.
• Conduct denial management and payer follow-up to secure timely and accurate reimbursement.
• Prepare and submit appeals and required supporting documentation for denied or underpaid claims.
• Maintain accurate and complete patient billing records and documentation in compliance with HIPAA and payer requirements.
• Work closely with laboratory accessioning and operations teams to identify and correct billing discrepancies at the front end of the revenue cycle.
• Monitor claim status and aging accounts receivable reports to ensure timely collections and escalate unresolved items appropriately.
• Ensure compliance with payer policies, Medicare/Medicaid billing regulations, and applicable laboratory billing guidelines, including LCD/NCD requirements.
• Support internal audits, compliance reviews, and payer audit responses as needed.
REQUIRED QUALIFICATIONS
• Minimum 2 years of experience in healthcare billing or laboratory revenue cycle operations.
• Working knowledge of CPT coding and ICD-10-CM diagnosis coding applicable to clinical laboratory services.
• Experience with Medicare, Medicaid, and commercial payer claim submission and follow-up processes.
• Strong attention to detail with a high degree of accuracy in data entry and claims documentation.
• Strong analytical abilities for identifying underpayment and overpayment trends, billing discrepancies, and denial patterns.
• Effective organizational and time management skills with the ability to manage multiple priorities in a high-volume environment.
PREFERRED QUALIFICATIONS
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent billing/coding certification.
• Experience with pharmacogenomics (PGx) or molecular diagnostic laboratory billing and applicable LCD coverage policies.
• Familiarity with laboratory information systems (LIS) and billing platform integrations.
• Prior experience in a multi-site or roll-up laboratory billing environment.
WORK LOCATION
Work Location Note: This is a 100% on-site position. Candidates must be able to commute daily to either our Miramar Beach, Florida, or Milledgeville, Georgia office. Remote work and telecommuting are not available for this role.
This job description is not an exhaustive list of all functions the employee may be required to perform. Labarium Diagnostic Systems, Inc. reserves the right to revise or change job duties and responsibilities as business needs dictate. This document does not constitute a written or implied contract of employment.