Qureos Mentor

Acutis Diagnostics Inc.

<p></p><div><h4 class="jobSectionHeader"><b>Job Summary-</b></h4><p>
The RCM Billing Supervisor for Toxicology and Molecular Diagnostics is responsible for managing the end-to-end billing operations for specialized lab services. This includes overseeing claim submissions, denial management, payer compliance, and team performance. The role requires deep expertise in lab-specific CPT/HCPCS codes, payer policies, and evolving molecular testing regulations.</p>
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Key Responsibilities-</p>
<h4 class="jobSectionHeader"><b>
Billing Oversight -</b></h4><ul><li>
Supervise daily billing operations for toxicology (e.g., drug screening, confirmation testing) and molecular diagnostics (e.g., PCR, genetic testing).</li><li>
Ensure accurate charge capture and timely claim submission.</li><li>
Monitor clearinghouse rejections and resolve coding or modifier issues.</li></ul><h4 class="jobSectionHeader"><b>
Team Management -</b></h4><ul><li>
Lead and mentor billing staff; conduct training on labspecific billing protocols.</li><li>
Develop SOPs for toxicology and molecular diagnostics billing workflows.</li><li>
Conduct performance reviews and support staff development.</li></ul><p>
Denial &amp; AR Management -</p>
<ul><li>
Analyze denial trends (e.g., PR55, CO197) and implement corrective actions.</li><li>
Oversee AR followup and ensure timely resolution of unpaid or underpaid claims.</li><li>
Collaborate with payers and labs to resolve complex billing issues.</li></ul><h4 class="jobSectionHeader"><b>
Compliance &amp; Quality -</b></h4><ul><li>
Ensure compliance with CMS, CLIA, and payerspecific lab billing guidelines.</li><li>
Stay current with changes in molecular diagnostics billing (e.g., PLA codes, NCDs).</li><li>
Conduct internal audits to ensure coding accuracy and documentation integrity.</li></ul><h4 class="jobSectionHeader"><b>
Reporting &amp; Analytics -</b></h4><ul><li>
Track KPIs such as Clean Claim Rate, Denial Rate, and DSO.</li><li>
Generate monthly reports and present insights to leadership.</li><li>
Recommend process improvements based on data trends.</li></ul><p>
Qualifications</p>
<h4 class="jobSectionHeader"><b>
Education &amp; Experience</b></h4><ul><li>
Bachelor&rsquo;s degree or appropriate accreditation in Healthcare Administration, Business, or related field.</li><li>
35 years of experience in lab billing, with at least 2 years in toxicology or molecular diagnostics.</li><li>
Prior supervisory experience in a healthcare billing environment.</li></ul><h4 class="jobSectionHeader"><b>
Skills &amp; Knowledge</b></h4><ul><li>
Strong knowledge of CPT codes (e.g., 8030580307, G0480G0483, 814xx series).</li><li>
Familiarity with payerspecific rules for highcomplexity lab testing.</li><li>
Prior Xifin experience is preferred.</li><li>
Proficiency in LIS, billing software, and clearinghouse platforms.</li><li>
Excellent leadership, communication, and analytical skills.</li></ul><h4 class="jobSectionHeader"><b>
About Acutis Diagnostics Inc</b></h4>
Acutis is a specialized medical laboratory that complements hard science with a service-first mindset. We are a growing clinical laboratory headquartered in Hicksville, NY. We pride ourselves on providing expert, accurate and concise results as a product of our highly talented and passionate team of professionals. We believe the team we build today will be the foundation of our future success.</div><p></p>

Revenue Cycle Billing Supervisor

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Acutis Diagnostics Inc.

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Revenue Cycle Billing Supervisor