Laboratory Billing & Compliance Strategist

Phoenix Children's Hospital, Inc.; Phoenix, Northern (AZ, KY); Hybrid; USD 65,000 - 95,000; Full time

Job summary

Phoenix Children's Hospital, Inc. is seeking a Laboratory Business Operations Specialist to optimize billing for hospital laboratory and pathology services. You will review errors, verify CPT codes, and support revenue cycle teams while ensuring compliance with payor requirements.

The role emphasizes auditing, standardizing processes, and collaborating with Revenue Integrity and billing teams to maintain accurate, timely invoicing and adherence to regulations.

Qualifications

• Bachelor's degree in a relevant field or an Associate's degree with two years billing compliance experience.
• Advanced experience in laboratory coding, billing and invoicing.
• Comprehensive CPT coding, HCPCS modifiers and payor guidelines knowledge.

Responsibilities

• Review billing system error reports and resolve exceptions; analyze patterns and escalate issues.
• Provide billing operational support including error processing, charge entry and CPT verification.
• Develop internal audits and quality controls in line with applicable laws.
• Lead standardization of laboratory billing processes and update SOPs.
• Review referral lab invoices for pricing accuracy and timely payment approvals.
• Monitor CMS and commercial payer rules and communicate changes.
• Maintain ChargeMaster audits with Revenue Integrity and ensure compliance.

Skills

Independent work

Attention to detail

Excel proficiency

CPT/Coding knowledge

Education

Bachelor's Degree or Associate's Degree with 2+ years billing compliance experience

Tools

Allscripts

SunQuest LIS

Image Express

Job description

Phoenix Children's Hospital, Inc. is seeking a Laboratory Business Operations Specialist to optimize billing for hospital laboratory and pathology services. You will review errors, verify CPT codes, and support revenue cycle teams while ensuring compliance with payor requirements.

The role emphasizes auditing, standardizing processes, and collaborating with Revenue Integrity and billing teams to maintain accurate, timely invoicing and adherence to regulations.