Diagnostics Revenue Cycle Specialist

Diagnostics Revenue Cycle Specialist Responsibilities · Oversee end-to-end revenue cycle processes for diagnostic services, including charge capture, coding, billing, and collections · Verify patient insurance eligibility and benefits for diagnostic procedures · Review and validate diagnostic test orders, documentation, and medical necessity requirements · Maintain accurate patient billing records · Ensure accurate coding using CPT, ICD-10, and HCPCS systems · Prepare claims for submission to insurance carriers and follow up on unpaid or denied claims · Analyze and resolve claim rejections, denials, and underpayments · Monitor aging reports and prioritize collection efforts · Ensure compliance with federal and state regulations, including HIPAA and payer-specific guidelines · Collaborate with management to improve documentation and billing accuracy · Identify trends in denials and recommend process improvements Requirements · High school diploma or equivalent · 2+ years of experience in medical billing, preferably in diagnostics (lab, radiology, or pathology) · Strong knowledge of LCDs, NCDs, Payor Policies, CPT, ICD-10, and HCPCS coding systems · Experience with insurance large customer base and high transaction volume of claims, EOBs, and reimbursement processes · Familiarity with EHR and billing systems · Excellent analytical, organizational, and problem-solving skills · Strong attention to detail and accuracy · Proficiency with Microsoft Office Suite · Ability to prioritize and manage time appropriately We are an Equal Opportunity Employer and committed to providing reasonable accommodations to individuals with disabilities. If you require accommodations during the application or interview process, please contact [email protected]. 7:30 AM to 4:30 PM, Monday through Friday