University of Rochester Lead Billing/Acct Spec in Rochester, New York


Full Time 40 hours Grade 009 Lab Admin-Clin Labs SMH


Position Summary: Under the general direction of the Lab Billing Manager, and with latitude for independent judgment and initiative, serves as the lead processor for Pathology's billing operations. Works closely with other Lab billing staff, Patient Financial Services, Pathology operations, Clinical Departments, and other internal and external staff to improve all billing operations. Responsible for full cycle review and oversight of the complex, high value billing while working to improve billing efficiency and collectability.

Specific Responsibilities:

Oversees the special procedure billing processes, monitoring the process and providing feedback and updates to other stakeholders as needed. Ensures a closed loop process from initial charging to final adjudication of special procedure testing.

Responsible for review and resolution of pre-billing edits of complex, high value, testing to ensure compliance with all third party billing and regulatory requirements.

Receives and investigates denied high value claims, or other claims as assigned, and, based on that analysis, recommends appropriate process changes to improve the rate of clean-claim submissions.

Provides oversight of Highland Hospital's Pathology billing, responsible for all HH Lab work queues.

Acts as a general resource to internal and external staff for alt high value Pathology-related billing concerns.

Provides education and training to other Lab Billing staff and is primarily responsible for writing Lab Billing SOPs.

Assists with other daily tasks as assigned including leading or helping with special projects.

Assists in the monitoring and reporting of billing performance and staff productivity metrics.

Performs other responsibilities and projects as assigned.


Associate's degree in a business field or with a business or financial concentration preferred, and 4-5 years of related experience, preferably in health care billing or coding or on equivalent combination of education and experience. Experience as a group Lead, preferably in the health care field, is a plus.

Models leadership skills of professionalism, positive attitude, team building, effective and thoughtful judgment, and respect. Demonstrates effective and professional written and oral communication skills. Demonstrates knowledge and understanding of health cm billing and finance operations. Understands the guidelines and standards of CMS and other third party payers. Maintains a working understanding of Lab, PFS, Hospital, and Ambulatory operations. Fluent in use and value of computer based tools and platforms 10 help process and monitor billing operations.

EOE Minorities/Females/Protected Veterans/Disabled

Job Title: Lead Billing/Acct Spec

Location: Strong Memorial Hospital

Job ID: 209269

Regular/Temporary: Regular

Full/Part Time: Full-Time