Sr. Process Associates- Lab Billing

Job Description

Med Karma is a premier international medical billing company headquartered in the United States. We specialize in delivering end-to-end revenue cycle management solutions for healthcare providers, with a focus on accuracy, compliance, and operational efficiency. With a global footprint and a commitment to excellence, Med Karma supports medical practices, hospitals, and healthcare organizations in maximizing revenue and improving patient outcomes. Our team is driven by innovation, integrity, and a deep understanding of the ever-evolving healthcare landscape. Join us and be part of a company thats redefining medical billing through expertise and personalized service.

Website: www.medkarmarcm.com

Job Description:

Revenue Cycle Management Laboratory/Pathology Billing

Job Summary: We are seeking a highly skilled and detail-oriented Revenue Cycle Manager with expertise in laboratory and pathology billing to oversee and optimize the entire revenue cycle process. This role is responsible for ensuring the accurate and timely submission of claims, managing billing workflows, overseeing accounts receivable, ensuring compliance with regulations, and driving operational improvements to maximize revenue for the laboratory or pathology department.

Key Responsibilities:

1. Billing & Claims Management:

Oversee the billing process for laboratory/pathology services, ensuring all charges are accurate and comply with payer requirements.

Ensure proper coding (CPT, ICD-10, HCPCS, etc.) for laboratory and pathology procedures.

Submit clean claims to insurance payers and follow up on any denials or rejections.

Ensure compliance with industry standards (CMS, HIPAA, and other relevant regulations).

2. Accounts Receivable Management:

Monitor accounts receivable (AR) to ensure timely payments from insurance companies, patients, and other responsible parties.

Identify and address any AR issues such as denied claims, underpayments, or coding errors.

Work closely with the collections team to resolve aged or overdue accounts.

3. Compliance and Regulatory Adherence:

Stay up to date with changes in laboratory/pathology billing regulations and payer policies.

Ensure all billing practices are compliant with federal, state, and payer-specific regulations.

Prepare and submit required reports for audits and regulatory reviews.

4. Denial Management and Appeals:

Manage the denial management process, reviewing and analyzing denial reasons and taking corrective actions.

Prepare and submit appeals for denied claims in a timely manner.

Track and report on denial trends to improve future billing processes.

5. Reporting and Analysis:

Prepare weekly, monthly, and quarterly reports on key revenue cycle metrics (e.g., days in AR, cash collections, denials, etc.).

Analyze trends in the billing and revenue cycle process and make recommendations for process improvements.

Provide insights to leadership to drive operational efficiency and revenue optimization.

6. Ownership & Collaboration:

Lead and mentor a team of billing and coding specialists, ensuring accurate and efficient billing practices.

Collaborate with laboratory/pathology managers, providers, and clinical staff to ensure correct documentation and coding for services rendered.

Coordinate with the cross-functional department to ensure the billing system is optimized for accuracy and efficiency.

7. Patient Billing and Customer Service:

Oversee patient billing inquiries and ensure timely resolution of any billing disputes.

Provide excellent customer service by addressing patient concerns regarding statements, charges, and insurance issues.

Qualifications:

Bachelors degree in Health Administration, Business, or a related field (or equivalent experience).

Minimum of 3-5 years of experience in revenue cycle management, with a focus on laboratory or pathology billing.

Strong knowledge of ICD-10, CPT, HCPCS, and laboratory/pathology coding and billing practices.

Experience with healthcare billing software and electronic health records (EHR) systems.

In-depth understanding of insurance processes, payer policies, and government regulations.

Proven ability to lead and manage teams effectively.

Excellent problem-solving, analytical, and communication skills.

Ability to work independently and prioritize tasks in a fast-paced environment.

Certification in medical billing (e.g., Certified Professional Coder (CPC), Certified Billing and Coding Specialist (CBCS)) is a plus.

Work Environment:

Opportunties , depending on the organizations structure.

Full-time position with potential for overtime based on workload.

Why work with us

Multicultural environment to explore, learn and grow.

Best remuneration, Incentives and bonuses, free Cab and Food facilities.

Wide range of training and certifications available for career development.

How to Apply: DM your resumes, contact at 7087871901 or email at [Confidential Information]

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