Genetic Lab Billing Specialist

2 days ago


Albany, New York, United States Tesis Labs LLC Full time
Job Overview

Tesis Labs LLC is seeking a skilled professional to join our team as a Genetic Lab Billing Specialist. This role is responsible for managing all aspects of molecular genetic laboratory billing and revenue cycle management.

The ideal candidate will have experience in genetic lab billing, accounts receivables, and/or collections within a healthcare or insurance environment. They will be responsible for accurately interpreting patient insurance, prescription, and other health-related documentation, as well as conducting medical insurance verification and investigations for commercial and government payors.

Key Responsibilities:

  • Accurately interprets patient insurance, prescription, and other health-related documentation.
  • Conducts medical insurance verification and investigations for commercial and government payors.
  • Communicates with insurance companies, patients, providers, and prescribers to coordinate reimbursement and access solutions.
  • Reviews unpaid accounts to determine status and takes appropriate action to ensure payment.
  • Reviews all claims for compliance and completeness for claims submissions.
  • Researches available alternative funding options to reduce patient's financial burden.
  • Maintains a high degree of confidentiality due to access to sensitive information.
  • Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department.
  • Works with customers and affiliates on reporting, best practices, and strategic planning to optimize growth within a compliant environment.
  • Reviews and designs KPI to ensure proper financial performance of assigned Laboratory clients.
  • Follows all Medicare, Medicaid, and HIPAA regulations and requirements.

Requirements & Competencies:

  1. High school diploma or equivalent is required; undergraduate degree is preferred.
  2. Experience in genetic lab billing, accounts receivables, and/or collections within a healthcare or insurance environment is required.
  3. Computer proficiency - MS Office and Web-enabled applications strongly preferred.
  4. Customer service skills required.
  5. Understanding of the requirements of Medicaid, Medicare, and Insurance billing for genetic laboratories in all MAC's is required.
  6. 5 years' experience with Laboratory medical billing.
  7. 3 years minimum with Cancer Genomics billing.
  8. 1 year with R & D of molecular genetics panels.
  9. Certified Medical coder or biller with AHIMA or affiliated organization.
  10. Experience with managing clients and/or employees preferred.


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