TPIRC is a non-profit clinical care and research center that focuses on the development of cutting-edge, individualized treatment protocols for rare and orphan diseases utilizing comprehensive diagnostic tools and patient-driven research. Our treatment programs are one of a kind with unmatched success rates. Our team is rapidly growing and we are looking for new members to support our mission.
We are currently seeking a Laboratory Billing Manager to join our growing team! The Laboratory Billing Manager directly leads and manages the overall operation of Patient Billing. Responsible for organization of staff functions in order to obtain optimal performance and fulfillment of the department goals and objectives in order to meet the overall success of the Revenue Cycle. Provide Leadership in ensuring that key metrics in the areas of claims status, reimbursements, efficiency of cash collections, and aging of accounts receivable.
Essential Duties and Responsibilities
- Oversee the Diagnostic Billing and Customer Service Team
- Establish relationships with Utilization Management and Contracting departments at major insurers, focused on establishing contracts and LOIs for services
- Develop and manage the process for submitting and tracking prior authorizations, communicating with payers and patients on approval and denials
- Review all claims for completeness and errors and correct them accordingly.
- In conjunction with our billing provider, review all denials for complexity, make corrections, and resubmit claims within 30 days of the denial received date.
- Responsible for running all billing reports, researching reports for re-bills, and maintaining report books by funding source.
- Assist with pulling all required medical billing documents needed for site sites for all clinics and administrative audits.
- Review weekly “billed” report with management.
- Generate weekly revenue report status to management team.
- Provides leadership in ensuring that the revenue cycle meets key metrics in the areas of days in A/R, efficiency of cash collections, and aging of accounts receivable.
- Routinely monitors operational processes, and verifies that policies and procedures are being followed and controls are working as intended.
- Monthly monitoring ensures that business risks are being identified and addressed. Findings are analyzed, summarized, and action is taken accordingly.
- BA / BS degree required; advanced degree in Life Sciences and Business preferred
- Minimum of 8 years of progressive operations experience with at least 3 years of demonstrated leadership and management responsibilities, preferably in a diagnostic laboratory setting
- Experience developing, implementing, monitoring, and analyzing departmental metrics
- At least 5 years of experience with billing and collection reimbursement processes, revenue cycle performance, financial intake, insurance verification, service authorizations, coding, submission and posting of claims, accounts receivable and collections.