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Department/Unit:

Laboratory Admininstration

Work Shift:

Day (United States of America)

Salary Range:

$46,220.72 - $64,709.01

The Clinical Pathology Billing / Coding Coordinator is responsible for all automated and manual billing related functions for the Albany Medical Center Laboratory. These functions include ensuring the accuracy of charges contained within the LIS and EHR systems, all laboratory charge and credit submission procedures, serving as the primary contact for all billing inquiries and discrepancies as they relate to laboratory testing, oversight of the Laboratory Billing Procedures Manual, working with the supervisors and IT specialist to validate new tests and systems, auto verification, billing charges, report review, and coordinating registration functions for the department to ensure timely and accurate posting or reversal of charges.

Essential Duties and Responsibilities

+ Identify milestones and critical path issues and develop a plan of implementation for new programs/projects.

+ Manage multifaceted projects using formal management tools.

+ Establish departmental controls that support and guide the mission and vision of the laboratory and the organization.

+ Assist laboratory directors and supervisors in the determination of appropriate technical coding, applying all appropriate CPT’s, modifiers, and payer billing rules and regulations in a timely and accurate fashion.

+ Ensure compliance with all billing related regulatory and voluntary standards of performance. Identify vulnerabilities and develop and implement an action plan to resolve issues.

+ Annually review and update all CPT’s throughout the laboratory.

+ Work department edits and EPIC work queues in a timely fashion to avoid billing delays.

+ Coordinate billing related functions for the laboratory.

+ Regularly review and maintain an accurate database for laboratory charges within the Laboratory Information System (LIS). Documents and follows up with appropriate staff on all discrepancies.

+ Prepares and submits request for new billing codes.

+ Work with Lab Client Services to contact the provider for missing/incomplete billing information including diagnoses and patient demographics.

+ Lead billing training sessions for laboratory leadership.

+ Work with patient accounts and finance in a collaborative and productive manner. Identify nonconformances and work with hospital leaders to find timely solutions.

+ Serve as a resource in resolution of health care system-wide issues.

+ Share organizational goals, objectives, strategic plans and other information with staff effectively and timely. Communicate staff concerns and issues with laboratory and/or hospital administration.

+ Coordinate and facilitate interactions among multi-disciplinary groups to achieve project/program objectives.

+ Follows established policies and procedures on laboratory compliance including the Correct Coding Initiative, charge submission protocols, and current Medicare regulations.

+ Collect and analyze data relating to patient billing. Notify hospital and laboratory leadership if any nonconformances are identified.

Qualifications

+ Associates degree in chemical, physical, biological science, or other applicable area required. Bachelor's degree preferred

+ CPC certification preferred

+ Clinical laboratory experience preferred

+ Medical coding experience, preferably with focus on laboratory testing, is preferred

+ Familiarity with ICD-10 diagnosis codes preferred

+ Prior experience with EPIC preferred, but consideration given to other hospital EHR systems

+ Working knowledge of Medicare rules and edit. CCI, OCE, APC, MUE, and modifier knowledge.

+ Familiarity with HIPAA regulations, medical terminology, healthcare finance, and billing processes.Thank you for your interest in Albany Medical Center!Albany Medical Center is an equal opportunity employer.This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

Thank you for your interest in Albany Medical Center!​

Albany Medical is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:

Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.