Location US-IL-Urbana

ID 2025-11118

Category

Support Services

Position Type

Full-Time

Remote

Yes

Shift

Day

Schedule

8-hour workdays M-F within time range: 730AM-5PM CST.

The Laboratory Billing & Coding Representative is responsible for accurate and timely billing of Laboratory services. Responsible for understanding medical terminology, patient registration, insurance eligibility, payer rules, CPT/HCPCS bundling, CCI modifiers, and lab-related coding for problem resolution. Responsible for understanding and applying compliance and regulatory guidelines to resolve charge review edits, claim edits, billing-related issues, and assigned work queues. Functions as a lab-billing resource for internal and external parties. This position uses Carle electronic medical record systems and Lab Information System to review clinical encounters and laboratory results.

• Responsible for resolving Lab-related CPT, HCPCS, and applicable ICD-10 inquiries for internal and external parties.
• Responsible for editing laboratory test charges to ensure CPT/HCPCS codes are appropriate for tests being billed and appropriate modifiers are applied. Ensures all charges are corrected when additional tests are ordered, or tests are cancelled at a later date.
• Responsible for researching and resolving assigned billing reports and work queues on a daily basis for registration errors, charge review, claim edits, etc.
• Responsible for understanding and applying compliance, regulatory, and CPT/HCPCS bundling rules for Laboratory billing.
• Facilitates maximization of revenue by ensuring correct coding initiatives and payer-specific guidelines are applied appropriately.
• Works collaboratively with Revenue Cycle, Coding, and other departments to resolve patient or payer-related charge and account inquiries, coding, denials, lab orders, trends, etc.
• Reconciles Referred (send-out) Testing invoices, calculates charges, keys billable services into systems, and reports discrepancies to appropriate internal and external parties.
• Communicates issues and trends to management to maintain departmental compliance and improve processes. Attends and provides input at meetings and trainings.
• Assists with Reference Laboratory billing processes.
• Assists with financial and statistical reports.
• Ensures quick responses to clients and patients regarding billing concerns.
• Ensures daily work assignments are complete by promoting teamwork and good communication.
• Assists with audits, special projects, and annual policy and procedure review process as requested.

Certifications: , Education: , Work Experience:

Find it here.

Discover the job, the career, the purpose you were meant for. The supportive and inclusive team where you can thrive. The place where growth meets balance – and opportunities meet flexibility. Find it all at Carle Health.

Based in Urbana, IL, Carle Health is a healthcare system with nearly 16,600 team members in its eight hospitals, physician groups and a variety of healthcare businesses. Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center hold Magnet® designations, the nation’s highest honor for nursing care. The system includes Methodist College and Carle Illinois College of Medicine, the world’s first engineering-based medical school, and Health Alliance™. We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: human.resources@carle.com.

The compensation range for this position is $22.4per hour - $37.41per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including, but not limited to, the candidate’s experience, qualifications, location, training, licenses, shifts worked and compensation model.



Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits.

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