Job Title: Laboratory Billing Supervisor

Company: TPIRC

Location: The Hub; Long Beach, CA

Hours: Full Time; Non Exempt; M-F 8AM-5PM

Pay Range: $33-36 per hour

Who We Are:

The Translational Pulmonary & Immunology Research Center (TPIRC) is a cutting-edge research and clinical care center that is revolutionizing treatment for rare and orphan diseases. Through the use of comprehensive diagnostic tools and patient-driven research, we seek to improve the quality of life for children and young adults each and every day.

Why TPIRC?

TPIRC is home to many innovative thinkers, problem solvers, and passionate leaders. The work we do is truly life-changing for our patients and their families; each member of our team will experience how their role supports our mission! TPIRC provides a challenging and rewarding environment where employees’ talents are leveraged, ideas are encouraged and growth is always inspired.

Who Are We Looking For?

We are currently seeking a supervisor for our laboratory billing department. This individual will have experience in medical billing and successful experience leading and developing a team. The Laboratory Billing Supervisor will ensure the accuracy and compliance of laboratory insurance claims and patient statements. This role supports the management of billing day-to-day operations and serves as a resource for patients, teammates, and escalations. This role works directly with patients, insurance companies, financial counselors, scheduling, business office, and clinical departments to ensure all records are up-to- date, compliant with billing and coding guidelines, and consistent. The Laboratory Billing Supervisor will demonstrate knowledge in laboratory billing, the medical billing process and will serve as the laboratory billing and coding expert for the organization.

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Benefits:

• Health Insurance
• Vision Insurance
• Dental Insurance
• PTO Days
• Paid Holidays
• 401K Plan (matched)
• Professional Development
• Paid Training
• Company Sponsored Events
• Competitive Rates
  
• Growth Opportunities

Essential Functions:

Supervisory Responsibilities:

• The supervisor supports management with day-to-day billing operations and works closely with department management and ensures a high level of performance with a commitment to continuous improvement.
• The supervisor works cross-functionally with other departments to support company goals and business growth.
• The supervisor assists with department workload and provides support to staff, as directed.
• The supervisor applies independent judgement, research and knowledge to audit billing and coding issues.
• The supervisor will provide daily/weekly status reports to management.
• The supervisor will ensure staff accountability and performance and escalate to management when delays in billing occur.
• The supervisor will assist with recruitment and onboarding process of new hires.
• The supervisor will assist with training and development of the team.
• The supervisor will QC the billing team’s work to ensure consistency and accuracy.
• The supervisor will manage employee productivity.
• The supervisor will manage employee attendance, schedules, and timesheets.
• The supervisor will assist with employee performance reviews, ongoing and annually.

Laboratory Billing:

• The supervisor is responsible for the timely submission of laboratory claims to various payors.
• The supervisor will contribute to workflow improvements.
• Prepare, review, and transmit claims for electronic and/or paper claim submission from the billing CRM.
• Responsible for resolving claim edits and clearinghouse rejections via the billing CRM.
• Responsible for processing all secondary claims via electronic and/or paper claim submission.
• Responsible for submitting claims with required documents, per payor guidelines or as requested (i.e., medical records).
• Review patient statements for accuracy and completeness prior to billing.
• Maintain a current understanding of local coverage determinations, payor, and coding guidelines to ensure claims are consistently billed properly.
• Perform charge reconciliation from the daily appointment schedule.
• Perform posting of charges, electronic and/or manual to the billing CRM.
• Keep abreast with medical coding updates, specifically for laboratory services, and educate team members of changes in a timely manner.
• The supervisor will maintain confidentiality and is knowledgeable of AMA CPT, HCPCS, and ICD codes and HIPPA guidelines.
• Ensure patient and insurance demographics is accurate.
• Enter and make the appropriate changes in the billing CRM(s) and Salesforce regarding insurance and eligibility, and insurance information, as needed.
• Respond to email and phone calls related to billing and claim submissions.
• Verify eligibility and benefits using a real-time system response, through health plan portals, and/or via telephone to the health plan and/or guarantor.
• Ensure appropriate authorization or referral numbers are on the claim prior to submission.
• Performs job duties with oversight.
• Other duties as assigned.

General:

• Maintain key performance metrics related to billing.
• Assist with the development, implementation and maintenance of workflow, policies and procedures, forms, and manuals.
• Assist with the development and communication of Standard Operating Procedures (SOP) for key areas to improve accuracy and understanding of processes.
• Create and manage the daily, weekly, and monthly reporting metrics utilizing Excel and web-based software to track medical billing metrics.
• Collect and analyze data, prepare reports, and identify trends for improvement opportunities.
• Identify system/process issues and bring to management’s attention with possible solutions and/or suggestions.
• Interfaces with other departments to resolve operational workflows.
• Collaborate with patients or customers, third party institutions and other team members to research and resolve billing inconsistencies and errors.
• Collect and maintain patient demographic and medical information required for medical billing.
• Ensure patient documentation is scanned and filed correctly within the Electronic Medical Record (EMR.)
• Provide exceptional customer service.
• Maintain and understand various medical billing software platforms.
• Navigate insurance websites and answers customer inquiries.
• Understand office visit fees including procedure and diagnosis codes.
• Maintain confidentiality and adhere to HIPAA regulations.
• Complete assigned tickets as required.
• Adhere to policies and procedures, update of forms and manuals.
• Assist in development and communication of SOP for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Assist other staff and support the team approach.
• Communicate appropriately and clearly to management, co-workers, and physicians.
• Maintain all reference material that is provided by the supervisor, manager, or director.
• Know and follow the Employee Handbook policies and procedures.
• Maintain patient confidentiality so that HIPAA compliance is always observed.
• Demonstrate honesty and integrity in everyday activities.
• Arrive to work on time.
• Consistently be at work.

Qualifications:

• High School diploma or equivalent required.
• College degree in healthcare preferred (AA or BA/BS), or work experience equivalent.
• Customer Service experience required.
• 5+ years of experience in medical billing required.
• 5+ years of experience in laboratory billing preferred.
• Experienced with lab orders, panels ordering and the accessioning process.
• Experience managing/leading supporting teammates.
• Excellent interpersonal skills with peers and various levels of management
• Experience with preparing reports for trending and process improvement
• Comfortable navigating across various computer systems to locate critical information.
• Medical billing and coding certification preferred.
• Knowledge of insurance policies/guidelines, EOB (Explanation of Benefits), prior authorization/referral processes, medical terminology, CPT/ICD/HCPCS coding preferred.
• Experience with a CMS-1500 claim form.
• Experience working with clearinghouses for the purpose of claim submissions.
• Experience with payor portals and affiliates.
• Experience with billing CRMs.
• Experience with LIS preferred.
• Experience using Salesforce a plus.
• Must have strong analytical skills, proficient with spreadsheets.
• Knowledge of health networks, IPA, HMO, PPO and contract affiliations.
• Experience with out-of-network payors (billing, authorization, claim follow up).
• Exceptional organizational, presentation, and communication skills, both verbal and written.
• Proficiency in meeting deadlines and prioritize workload.
• Ability to work independently, with direction, and as part of a team.
  
• Experience with Microsoft Office Suite and Google Workspace.
• Self-motivated, team-oriented, very responsible, and focused on exceeding customer expectations.

Physical Requirements:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms. The employee is required to walk between multiple office locations that include the use of stairs (elevator is only available in some instances).

This position requires the ability to occasionally lift office products and supplies, up to 20 pounds.

The Translational Pulmonary and Immunology Research Center (TPIRC) provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, marital status, veteran status, or any other consideration made unlawful by federal, state, or local laws.

TPIRC is committed to providing reasonable accommodation for qualified applicants, and employees with disabilities to ensure they enjoy equal access to all employment opportunities and benefits of employment as required by the Americans with Disabilities Act. TPIRC is an Equal Opportunity Employer and participant in the U.S. Federal E-Verify program.