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Dental Biller

Company: Mercy Health System
Location: Janesville
Posted on: January 7, 2022

Job Description:

Department/Skill highlights Mercyhealth#Janesville This position comes with benefits!# # # # ## Beginning Summary Experience a rewarding and fulfilling career with Mercyhealth. Mercyhealth is committed to offering our partners a best place to work. Our unique workplace Culture of Excellence is built upon: Employee engagement, empowerment and growth Teamwork toward our common goal # providing exceptional health care services with a passion for making lives better An atmosphere of caring and quality that cascades throughout the organization Essential duties and Responsibilities Directs and oversees laboratory billing functions for the system laboratories. Manages process for billing miscellaneous tests system wide. Adjusts the process as necessary.# Completes the research and manual charge entry for billing of all miscellaneous tests for each system laboratory. Manages billing process for all significant exposures system wide. Monitors tests sent to reference labs and all tests not performed so that credits are made timely. Manages billing process for add on tests done by reference labs such as UW and DermPath and Mayo who perform Anatomic Pathology testing for Mercy.# Reviews reference laboratory invoices to research and add appropriate charges to clinical and anatomic pathology laboratory tests. Reviews reference lab invoices for errors and follows through to get credits applied to Mercyhealth accounts.# #Reviews and updates CPT and HCPCS coding for all new and miscellaneous tests as updates occur for submission to the lab chargemaster, and as needed for error corrections. # Proposes charges for new and updated tests to the chargemaster committee. Reviews annual CPT updates for implementation with IS and billing department as well as any interim updates that may occur during the year. Assures timely billing of laboratory claims that fall into a work queue by resolving the issue through addition of appropriate modifiers, transferring charges to the appropriate encounters, updating encounters with appropriate date of service and/or valid encounter numbers to clear all work queues assigned to the laboratory. Research denials and update claims through account maintenance. Following appropriate research, completes the add on and late charge/credit entries for pathology tests through manual charge entry utilizing the daily reference lab charge report for the system laboratories. Processes credits/cancellations of charges through LIS or through account maintenance when appropriate to do so such as when a test is not performed. Develops and revises charge/order entry processes to assure appropriate billing of all laboratory testing Insures compliance with regulatory and contract standards related to charging and reimbursement. Develops and updates procedures related to all billing functions. Educates appropriate partners on all procedures and updates. Manages all requests for new test builds.# Gathers required information and submits to IS. Coordinates with IS and appropriate lab partners for review of test builds. Assists IS with test build issues as needed. Assists IS with the research for test build issues with the reference laboratory interface.# Monitors reference lab updates and submits to IS. Research preauthorization requests to provide CPT codes to patient financial counselors for new tests.# Works with IS and lab director to develop appropriate on line Epic preauthorization forms. Analyzes current information systems as they relate to laboratory billing functions, identifies problems, makes recommendations and changes as needed to most effectively utilize software applications. Research customer comment cards as related to billing issues. Provide information to manager. Education and Experience Minimum of 5 years# experience working with billing and/or lab information support systems and functions. # Special Physical Demands The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations. While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; and reach with hands and arms. Specific vision abilities required by this job include close vision. Keywords LAB, Clia, Phlebotomist, Phlebotomy Department/Skill highlights * Mercyhealth Janesville * This position comes with benefits! Beginning Summary Experience a rewarding and fulfilling career with Mercyhealth. Mercyhealth is committed to offering our partners a best place to work. Our unique workplace Culture of Excellence is built upon: * Employee engagement, empowerment and growth * Teamwork toward our common goal - providing exceptional health care services with a passion for making lives better * An atmosphere of caring and quality that cascades throughout the organization Essential duties and Responsibilities * Directs and oversees laboratory billing functions for the system laboratories. * Manages process for billing miscellaneous tests system wide. Adjusts the process as necessary. Completes the research and manual charge entry for billing of all miscellaneous tests for each system laboratory. * Manages billing process for all significant exposures system wide. * Monitors tests sent to reference labs and all tests not performed so that credits are made timely. * Manages billing process for add on tests done by reference labs such as UW and DermPath and Mayo who perform Anatomic Pathology testing for Mercy. Reviews reference laboratory invoices to research and add appropriate charges to clinical and anatomic pathology laboratory tests. * Reviews reference lab invoices for errors and follows through to get credits applied to Mercyhealth accounts. * Reviews and updates CPT and HCPCS coding for all new and miscellaneous tests as updates occur for submission to the lab chargemaster, and as needed for error corrections. * Proposes charges for new and updated tests to the chargemaster committee. * Reviews annual CPT updates for implementation with IS and billing department as well as any interim updates that may occur during the year. * Assures timely billing of laboratory claims that fall into a work queue by resolving the issue through addition of appropriate modifiers, transferring charges to the appropriate encounters, updating encounters with appropriate date of service and/or valid encounter numbers to clear all work queues assigned to the laboratory. * Research denials and update claims through account maintenance. * Following appropriate research, completes the add on and late charge/credit entries for pathology tests through manual charge entry utilizing the daily reference lab charge report for the system laboratories. * Processes credits/cancellations of charges through LIS or through account maintenance when appropriate to do so such as when a test is not performed. * Develops and revises charge/order entry processes to assure appropriate billing of all laboratory testing * Insures compliance with regulatory and contract standards related to charging and reimbursement. * Develops and updates procedures related to all billing functions. Educates appropriate partners on all procedures and updates. * Manages all requests for new test builds. Gathers required information and submits to IS. Coordinates with IS and appropriate lab partners for review of test builds. Assists IS with test build issues as needed. * Assists IS with the research for test build issues with the reference laboratory interface. Monitors reference lab updates and submits to IS. * Research preauthorization requests to provide CPT codes to patient financial counselors for new tests. Works with IS and lab director to develop appropriate on line Epic preauthorization forms. * Analyzes current information systems as they relate to laboratory billing functions, identifies problems, makes recommendations and changes as needed to most effectively utilize software applications. * Research customer comment cards as related to billing issues. Provide information to manager. Education and Experience * Minimum of 5 years' experience working with billing and/or lab information support systems and functions. Special Physical Demands * The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations. * While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; and reach with hands and arms. Specific vision abilities required by this job include close vision. Keywords LAB, Clia, Phlebotomist, Phlebotomy

Keywords: Mercy Health System, Janesville , Dental Biller, Healthcare , Janesville, Wisconsin

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