Lighthouse Lab Services is seeking a detail-oriented and experienced Medical Billing Specialist to join our team in Houston, TX, with a focus on PCR/Molecular diagnostics , specifically in wound and nail cases . The ideal candidate will be responsible for accurately processing insurance claims, posting payments, researching and resolving billing issues, and ensuring efficient revenue cycle operations. This role requires a strong understanding of medical billing practices, excellent problem-solving abilities, and alignment with the company's core values.
Key Responsibilities
Revenue Cycle Management
Accurately enter and verify patient demographics in billing software.
Validate insurance eligibility and coordination of benefits for clean claim submission.
Scrub claims and resubmissions to ensure accurate coding based on payer guidelines, provider, and billing group.
Post payments and adjustments from payers accurately and timely.
Review and work assigned/unassigned denials and unpaid claims.
Conduct timely follow-up with payers via phone or provider portals.
Issue Resolution and Communication
Identify denial and payment trends; communicate issues to management and team.
Research and resolve billing issues to ensure appropriate reimbursement.
Follow up on all payer and patient correspondence (electronic and paper).
Communicate effectively with insurance companies, clients, and patients to support billing and payment activities.
Compliance and Knowledge Maintenance
Maintain up-to-date knowledge of policies related to PCR/molecular diagnostics billing.
Ensure HIPAA compliance in all aspects of documentation and communication.
General Duties
Demonstrate behavior consistent with the Company’s Core Values.
Perform other tasks as assigned within the scope of the position.
Qualifications
Education
Required: High school diploma or GED
Preferred: Certificate in healthcare billing or medical coding
Experience
Required: Minimum 2 years in billing/coding for PCR/molecular diagnostics with specific experience in wound and nail diagnostics
Proficient in ICD-10, CPT, and HCPCS coding systems
Hands-on experience with denial research and resolution
Strong working knowledge of commercial and government insurance guidelines, EOBs, CMS1500, HCFAs
Benefits and Salary:
About Us:
At Lighthouse Lab Services, we offer solutions to help start, grow, and run clinical laboratories. Our recruiting team has over 21 years of proven success placing job seekers in positions ranging from entry level Medical Technologists to seasoned Laboratory Directors. We recruit nationwide, for permanent and travel positions with clients ranging from small hospitals to large reference laboratories.
It is the policy of Lighthouse Lab Services to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. Lighthouse Lab Services is committed to working and providing reasonable accommodation to individuals of all abilities, including persons with disabilities. If at any time during the application process, you need an accommodation, please contact recruiting@lighthouselabservices.com for assistance.
Lighthouse Lab Services | 800-838-0602 | lighthouselabservices.com
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