Position Summary Quality Forensic Toxicology (QFT) is seeking an organized and detail-oriented Certified Laboratory Medical Billing Specialist to support our internal billing operations and work closely with our third-party billing partners. This position supports both client invoicing and insurance revenue-cycle activities, helping ensure accurate billing information, complete documentation, timely claim follow-up, and appropriate reimbursement. The ideal candidate has at least two years of medical billing experience and a strong understanding of insurance verification, claims processing, denials, appeals, and reimbursement. Experience in laboratory, pathology, or other healthcare billing is strongly preferred. In-House Billing Responsibilities Prepare monthly client and project invoices by extracting billing information from the laboratory information system (LIS) and/or Excel reports. Apply the appropriate billing rates for each test or service. Create and issue client invoices. Manage outstanding in-house accounts receivable by sending statements, following up on unpaid invoices, and assisting with collection efforts. Accurately record and apply client payments once received. Maintain complete and accurate billing records and supporting documentation. Prepare end-of-month reports for in-house billing revenue. Prepare weekly and monthly case-volume reports. Identify billing discrepancies and work with internal departments to resolve issues. Third-Party Billing & Revenue Cycle Coordination Serve as QFT's primary internal point of contact for third-party billing companies. Work closely with billing partners to ensure complete and accurate information is submitted to insurance carriers. Review and verify patient insurance information and ensure accurate entry into the LIS. Review CPT codes assigned to cases for accuracy and escalate discrepancies as needed. Complete verification of benefits and review coverage information through payer portals when necessary. Monitor billing portals and identify claims or billing issues requiring additional information or documentation. Track outstanding claims, denials, and billing issues through resolution. Follow up with third-party billing partners regarding unresolved claims, denials, and reimbursement issues. Review denied or rejected claims to determine whether additional information or documentation may support resubmission or appeal. Coordinate with physician offices, internal staff, and billing partners to obtain medical records, insurance information, orders, and other documentation needed to support claim payment or appeals. Assist with payer requests for medical records and other supporting documentation. Help identify recurring billing, documentation, or ordering issues that may contribute to denials or delayed reimbursement. Assist management with monitoring billing performance, reimbursement trends, and outstanding issues. Help improve billing accuracy, claim resolution, and overall reimbursement outcomes. Required Qualifications Minimum of two years of medical billing experience required; five years preferred. Strong knowledge of insurance verification, benefits, claims processing, denials, appeals, and reimbursement workflows. Experience reviewing and following up on outstanding insurance claims. Strong attention to detail and the ability to identify errors, missing information, and documentation deficiencies. Excellent organizational, communication, and follow-up skills. Ability to manage multiple priorities and outstanding issues in a fast-paced environment. Proficiency with Microsoft Excel, Word, and Outlook. Ability to work effectively with third-party billing companies, insurance carriers, physician offices, and internal staff. Working knowledge of HIPAA and patient privacy requirements. Preferred Experience Certified Medical Biller or other recognized medical billing or coding certification. Knowledge of ICD-10 and CPT coding. Previous pathology or clinical laboratory billing experience. Experience working with Medicare, Medicaid, and commercial insurance carriers. Experience working with third-party billing or revenue-cycle management companies. Experience with claim denials, appeals, insurance follow-up, and accounts receivable. Familiarity with healthcare billing documentation requirements and lab workflows.

Pay:

$20.00 - $25.00 per hour Expected hours: 40.0 - 45.0 per week

Benefits:

Dental insurance Health insurance Health savings account Life insurance Paid time off Vision insurance

Work Location:

In person