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Job ID: 20188
Location: Chapel Hill, NC
Facility/Division: UNC Medical Center
Status: Full Time
Shift: Day Job
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.
Provides technical expertise in specific laboratory discipline or program specialty, monitor and direct the workload and provides consultative and diagnostic results to clinicians.
Works collaboratively with Managed Care, Denial Analysts and other Hospital and Professional Billing Specialists to track and address laboratory denials. Maintains and monitors daily reports for charges requiring prior authorization. Reviews patient records and submits prior authorization requests, including all pertinent clinical information, and monitors outcomes. Coordinates the appeal process with ordering providers for denied authorizations where necessary. Participates in laboratory denials committee meetings to identify areas of improvement in reimbursement outcomes. Works with Payor Teams and Laboratory Managers to monitor updates to national, local and corporate billing policies related to medical necessity and prior approval needs. Identifies internal and external resources to help facilitate prior authorization and denials reviews, determine best practices and establish standard procedures. Monitors for variances and tracks and presents findings to laboratory leadership
1. Collects and analyzes data to evaluate products, procedures, processes and laboratory or program needs.
2. Consults with healthcare providers and professionals regarding patient care and program issues.
3. Ensures compliance with regulatory guidelines. Establishes and reviews procedures and policies.
4. May monitor personnel performance, counsel employees and provide input into performance evaluations.
5. May provide input into budgetary process by identifying capital equipment needs and anticipating laboratory or program needs.
6. May teach Clinical Laboratory Science students, Pathology residents and fellows and new employees
7. Monitors daily operation of laboratory or program
8. Reviews patient testing results, quality control, maintenance, troubleshooting and management reports.
● Requires Bachelor's of Science degree.
● Requires MLS/MT (ASCP), MT (NCA) or MT (AMT) certification
Professional Experience Requirements:
● Requires three years of experience at the medical laboratory technologist, cytotechnologist, or histotechnologist level.
Knowledge/Skills/and Abilities Requirements:
Legal Employer: STATE
Entity: UNC Medical Center
Organization Unit: Department Of Hospital Labs
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: Yes
The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.
UNC Health is an equal opportunity employer. As such, UNC Health offers equal employment opportunities to applicants and employees without regard to race, color, religion, sex, national origin, age, genetic information, disability, sexual orientation, gender identity or political affiliation.