Ancillary Lab Biller

Summit Spine & Joint Centers; Georgia; On-site; USD 45,000 - 75,000; Full time

Benefits offered by this job

401(k) with company match

Paid time off (PTO)

Health benefits

Job summary

Summit Spine and Joint Centers is seeking a seasoned Medical Billing Specialist to audit lab claim data, submit claims, and ensure accurate HCFA 1500 billing. The role requires familiarity with CPT/ICD-10 coding and payer guidelines and involves collaboration with the billing and compliance teams to meet end-of-month deadlines.

The ideal candidate has 3+ years of medical billing experience, experience with various payers, and proficiency in Microsoft Office and eClinicalWorks.

Qualifications

• Minimum of 3 years’ experience with medical billing or revenue cycle in a medical setting.
• 1 year of lab-specific billing experience.
• Experience with Medicare, Medicaid, Commercial insurance plans, Workers’ comp, and Personal Injury cases.
• Knowledge of CPT coding, ICD-10 coding and medical pre-certification protocols.
• Familiarity with office procedures and HIPAA compliance.

Responsibilities

• Audits and ensure lab claim information is complete and accurate.
• Claims submission and scrubbing of urinary drug screens.
• Ensures accurate and timely billing of HCFA 1500 claims.
• Files documented with date stamps, logs and signatures.
• Creates logs for providers of pending encounters and errors.
• Collaborates with billing staff, management and compliance to meet month-end deadlines.
• Handles clearinghouse rejections, prints, and mails secondaries.
• Responds to inquiries from insurance companies, patients, and providers.
• Understands CPT, ICD-10, HCPCS coding and modifiers.
• Knowledge of third-party payers including HMOs, PPOs, Medicare, Medicaid, Worker's Comp.

Skills

Microsoft Office

Attention to detail

Multi-tasking

Communication skills

Education

Bachelor’s degree preferred

Tools

eClinicalWorks

Spreadsheets

Job description

Company Overview:

Summit Spine and Joint Centers (SSJC) is a rapidly growing, multi-state Interventional Pain Management practice providing comprehensive clinical, surgical, and imaging services. With locations across Georgia, North Carolina, South Carolina, Tennessee, Florida, and Texas, our team is committed to delivering exceptional, patient-centered care through collaboration, innovation, and clinical excellence.

Company Overview:

Summit Spine and Joint Centers (SSJC) is a rapidly growing, multi-state Interventional Pain Management practice providing comprehensive clinical, surgical, and imaging services. With locations across Georgia, North Carolina, South Carolina, Tennessee, Florida, and Texas, our team is committed to delivering exceptional, patient-centered care through collaboration, innovation, and clinical excellence.

As one of the largest single-specialty pain management practices in the nation, SSJC continues to expand its network while investing in the people who make our success possible. We are seeking motivated, qualified professionals who are passionate about making a meaningful impact and contributing to our continued growth.

Job Duties:

• Audits and ensure lab claim information is complete and accurate.
• Claims submission and scrubbing of urinary drug screens
• Ensures accurate and timely billing of HCFA 1500 claims.
• Ensures that files are documented with appropriate information (i.e., date stamped, logged, signed, etc.).
• Creates logs for providers of pending medical encounters and or encounters with errors.
• Work directly with other billing staff, management, and compliance department to meet end of month closing deadlines.
• Able to work with clearinghouse rejections, print, and mail secondaries.
• Address inquiries from insurance companies, patients, and providers.
• Understands CPT, ICD10, HCPCS coding and modifiers.
• Knowledge of third-party payers, HMOs, PPOs, Medicare, Medicaid, Worker's Compensation, etc.
• Knowledge of ERAs, EOBs
• Knowledge of payer specific/LCD guidelines
• Understanding of health plan benefits (deductibles, copays, coinsurance) and eligibility verification
• Must be proficient with spreadsheets and word processing applications.

Qualifications:

• Minimum of 3 years’ experience with medical billing or revenue cycle in a medical setting, 1 year of lab specific billing
• Experience with Medicare, Medicaid, Commercial insurance plans, Workers’ comp, and Personal Injury cases.
• Knowledge of claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management
• Knowledge of medical billing rules, such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials.
• Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols required.
• Excellent computer skills and familiarity with Microsoft Office
• Comfortable working in a growing, dynamic organization and able to navigate change.
• Self-motivated with ability to multi-task, prioritize work in a fast-paced, team environment.
• Bachelor’s degree preferred.
• Experience using eClinicalWorks preferred.
• Experience with Pain Management preferred.

Preferred Location

While this is a remote position, preference will be given to candidates residing in one of the following states:

• Georgia
• Texas
• North Carolina
• South Carolina
• Florida

Candidates located in Georgia should be able to attend meetings or training at our Lawrenceville administrative office as needed.

Compensation & Benefits

This is a full-time position offering a competitive salary, paid time off (PTO), comprehensive health benefits, and a 401(k) with company match.

The employee must communicate professionally, respectfully, and effectively with patients, visitors, clinicians, coworkers, and vendors, including in busy, demanding, or stressful circumstances. The employee must maintain professional composure and consistently perform assigned duties throughout the scheduled work period; manage routine workplace stressors and feedback without disrupting patient care, patient-facing operations, and coworkers’ work; and use established de-escalation and escalation procedures when appropriate. The employee must exercise sound judgment; maintain appropriate workplace boundaries; receive and respond to routine feedback and direction; protect confidential patient and business information; and address patient or workplace concerns through established supervisory and safety procedures. These functions are essential to the position.