Laboratory Biller in Los Angeles, California at Primex Clinical Laboratories Inc
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Job Description
At Primex Clinical Laboratories, we're dedicated to enhancing health with precision and passion. Since 1996, our presence in clinical diagnostics has been unwavering, serving clients across Central and Southern California, Nevada, and American Samoa. We pride ourselves on delivering personalized service and high-quality testing with quick, accurate results.
Job OverviewPrimex Clinical Laboratories is seeking an experienced Laboratory Biller to manage and optimize our revenue cycle. In this mid‑level role, you will prepare and submit high‑volume insurance claims, generate invoices for direct‑pay patients and corporate clients, and ensure accurate, compliant billing practices. You will collaborate with clinical, administrative, and finance teams to resolve issues and maximize reimbursement.
Key ResponsibilitiesClaims Submission: Prepare and submit clean claims to commercial insurers, Medicare, and Medi‑Cal using accurate CPT, ICD‑10, and HCPCS codes.
Invoicing: Generate and distribute invoices for self‑pay patients and direct client accounts, ensuring pricing aligns with contractual agreements.
Eligibility Verification: Confirm patient insurance coverage and obtain necessary pre‑authorizations before billing.
Denial Management: Investigate claim denials and rejections, identify root causes (coding, eligibility, documentation), and resubmit corrected claims or file appeals.
Payment Posting & Reconciliation: Accurately post and reconcile insurance and patient payments, ensuring all adjustments are documented and accounts are balanced.
Customer & Provider Support: Respond promptly to billing inquiries from patients, providers, and payers—clearly explaining charges, coverage, and payment options.
Cross‑Functional Collaboration: Partner with lab operations, client services, and IT teams to clarify service details, resolve billing discrepancies, and implement system improvements.
Compliance & Documentation: Maintain up‑to‑date knowledge of billing regulations (HIPAA, CMS guidelines) and ensure all billing activities adhere to company policy and legal requirements.
Reporting & Analytics: Produce regular billing performance reports (e.g., claim turnaround times, denial rates, aging analysis) and recommend process enhancements.
Experience: 2–3 years of laboratory or medical billing experience in a high‑volume environment.
Technical Proficiency: Hands‑on experience with billing software (e.g., Kareo, AdvancedMD) and clearinghouses, plus strong Excel skills for data analysis.
Coding Expertise: Solid understanding of CPT and ICD‑10 coding conventions, with a keen eye for detail.
Communication Skills: Professional, patient‑focused communication; ability to explain complex billing information in plain language.
Organizational Skills: Exceptional attention to detail with the ability to juggle multiple tasks, meet deadlines, and own your work.
Problem‑Solving: Proactive in identifying issues and driving resolutions to ensure timely reimbursement.