Responsible for investigating, resolving, and preventing billing issues related to laboratory testing services.
This role serves as a key liaison between patients, clients, health plans, laboratories, providers, and internal departments to ensure accurate billing, timely reimbursement, and exceptional customer service. The specialist analyzes complex billing discrepancies, researches insurance denials, resolves claim issues, and identifies opportunities to improve billing processes and reduce revenue leakage.
The position is a full-time hybrid role based in Santa Ana, CA, with on-site work required for 50% of weekly hours.
Requirements & Qualifications
Required
- High school diploma or equivalent
- Minimum of 2 years of experience in healthcare billing, medical claims processing, revenue cycle management, or insurance collections
- Knowledge of medical terminology, insurance billing processes, and healthcare reimbursement methodologies
- Experience researching and resolving claim denials and billing discrepancies
- Strong analytical and problem-solving skills
- Excellent verbal and written communication skills
- Proficiency with Microsoft Office applications, particularly Excel
- Ability to prioritize workload, manage multiple cases, and meet deadlines
Preferred
- Associate's or Bachelor's degree in Healthcare Administration, Business, Finance, or related field
- Experience with clinical laboratory or diagnostic testing billing
- Knowledge of CPT, ICD-10, HCPCS, and laboratory coding requirements
- Experience working with Medicare, Medicaid, commercial insurers, and managed care organizations
- Familiarity with electronic health records (EHR), laboratory information systems (LIS), and billing software
Knowledge, Skills, and Abilities
- Strong investigative and critical-thinking capabilities
- Ability to interpret insurance policies, reimbursement guidelines, and contractual requirements
- Exceptional customer service orientation and conflict-resolution skills
- Ability to handle sensitive and confidential information appropriately
- Strong attention to detail and accuracy
- Ability to work independently while collaborating effectively across departments
- Demonstrated ability to identify trends and recommend operational improvements
Location
Santa Ana, California, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago