Primary Purpose 

Responsible for the oversight, integrity, supervision, and maintenance of the Charge Description Master (CDM), charge capture process, and billing and coding regulatory compliance for laboratory services. Must be knowledgeable of current coding practices and identify ways to help address preventable revenue loss. Advise and collaborate with compliance, audit services, IT, patient financial services, and finance & revenue cycle teams to assess and solve billing, coding, and charging compliance issues. Act as a liaison to both internal and external lab billing business partners. Position works in a complex matrixed environment.

Major Responsibilities 

Maintains a working knowledge of the ICD-10 and CPT/HCPCS coding principles and the AMS/CMS Documentation guidelines. Works with revenue producing departments to ensure consistency with chargemaster and charge capture process including accurate descriptions, coding, additions, deletions, pricing, revenue codes, and any other changes.  Collaborates with finance, revenue recognition, and performance service departments to perform applicable analyses to understand budget variances, net revenue change, and labor impact of proposed changes to chargemaster. Maintains working knowledge of revenue cycle process to aid in the implementation of regulatory standards that assist the organization in cash collection while accurately complying with billing guidelines.  Responsible for revenue code and coding assignment of all new items or services throughout laboratory services.  Stays current with applicable government rules and regulations, payer changes, and compliance billing integrity resources and information.  Solves charging and billing problems by researching and analyzing end-to-end workflow across LIS and EHR.  Serves as resource to support problem-solving around interface testing, workflow design and charge testing, and other billing/charge related issues. Acts as a laboratory subject matter expert by identifying and evaluating CPT code changes. Establishes new line items and charges and provides education to operational leaders. Coordinates with internal lab operations, practice managers, Central Billing Office (CBO), etc. to address operational issues that are contributing to denials. Acts deliberately and systematically under pressure and projects confidence and a positive role model attitude. Ability to maintain organization and productivity under heavy workload situations. Exhibits confidence and leadership to team under pressure situations. Communicates unusual occurrences that may require immediate attention. Documentation is consistent, well-organized, and retrievable. Designs and directs the work of the team(s). Selects, coaches, and develops team(s). Sets clear expectations to inspire and motivate the team. Manages performance by recognizing achievement, providing feedback, and administering progressive discipline when necessary. May develop and/or recommend operating and capital budgets and controls expenditures within approved budget objectives. Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that people actions, and the actions of employees supervised, comply with the policies, regulations, and laws applicable to the organization's business.

Minimum Job Requirements 

Education: Bachelor’s Degree in healthcare administration, business or related field. 

Certification / Registration / License:  Certified Coder

Work Experience: Typically requires three years of supervisory/leadership experience in medical billing, laboratory, third party payers and/or managing accounts receivables.  Requires at least three years of coding experience for multiple specialties. 

Knowledge / Skills / Abilities 

Knowledge of medical terminology and anatomy and physiology Excellent interpersonal and communication (including excellent verbal and writing skills). Proven ability to handle multiple tasks and meet deadlines within standards. Adaptable and flexible with the ability to adapt, drive, and manage change. Proficient in Microsoft Windows Applications, including advanced Excel knowledge.  Demonstrated use of critical thinking skills to problem-solve. Experience working in PeopleSoft, EPIC and LIS

Strong communication and EPIC experience preferred.

Physical Requirements and Working Conditions 

Must possess physical characteristics to perform essential job functions.  Must be willing to work flexible hours, as needed.