Offer summary

Qualifications:

At least 3 years of experience in laboratory revenue cycle management., Strong knowledge of CPT coding, CLIA regulations, and insurance payer rules., Experience with billing systems like eClinicalWorks or similar., Familiarity with Texas Medicaid and Medicare lab reimbursement policies..

Key responsibilities:

Manage end-to-end lab billing processes, including test code mapping and claim submission.

Ensure billing compliance with Medicare and commercial insurance.

Collaborate with clinical, operations, and finance teams for accurate documentation and coding.

Monitor key performance indicators and implement improvement strategies.

Job description

About Us:
Total Primary Care is one of Texas’ largest independent primary care groups, focused on delivering high-quality, affordable healthcare through a network of modern, patient-centered clinics. As we expand our in-house laboratory services, we’re seeking a highly skilled Lab Revenue Cycle Manager to oversee and optimize billing operations for our growing POL footprint.

Key Responsibilities:

Manage end-to-end lab billing processes, including test code mapping, charge entry, claim submission, and denials management
Ensure billing compliance with Medicare and commercial insurance for laboratory services
Work cross-functionally with clinical, operations, and finance teams to ensure accurate documentation and coding
Track key performance indicators (AR days, denial rates, reimbursement trends) and implement strategies for improvement
Stay current on CLIA, CMS, and payer-specific rules that affect lab billing and reimbursement
Supervise billing staff or outsourced vendors (as applicable)

Qualifications:

3+ years of experience in laboratory revenue cycle management, preferably in a physician office lab (POL) environment
Strong knowledge of CPT coding, CLIA regulations, and insurance payer rules for lab services
Experience with billing systems such as eClinicalWorks or similar
Familiarity with Texas Medicaid and Medicare lab reimbursement policies
Detail-oriented with strong analytical and communication skills

Required profile