Lab Insurance Billing and Account Analyst

Position Summary:
The Lab Insurance Billing and Account Analyst is responsible for ensuring accurate, efficient processing of insurance claims by resolving denials, securing missing information, by locating missing account data in EPIC. This role acts as the central liaison between billing and front office staff—particularly when authorizations, documentation, or coding details are missing. The liaison helps secure timely reimbursement and reduce avoidable denials through proactive communication and problem-solving.

Key Responsibilities

• Review insurance denials, rejections, and returned claims to identify missing documentation, authorization gaps or eligibility problems.
• Locate required information within the EPIC system, including notes, orders, referrals, and scanned documents.
• Correct errors and resubmit claims according to payer-specific rules.
• Monitor recurring denial patterns and provide feedback for workflow improvements.

Authorization Support

• Identify accounts missing prior authorizations, referrals, or medical necessity documentation.
• Locate these authorizations in Epic
• Coordinate with clinics to obtain needed authorizations proactively or retroactively when appropriate.
• Prevent authorization-related denials by ensuring completeness before claim submission
• Process miscellaneous test EPIC work queues, including updating CPT/HCPCS codes and pricing
• Complete work queue tasks within established department turnaround times
• Request and obtain missing documents, orders, authorizations, ABNs, referrals, and insurance information needed to resolve claims, primarily through locating these in Epic.
• Provide timely updates on outstanding information and ensure follow-through.

Reporting & Documentation

• Document all actions taken on accounts with clear, detailed narrative notes in EPIC or Dataflex.
• Assist leadership with reporting trends related to denials, work queues, and authorization delays.
• Contribute to process improvement initiatives and updates to department procedures.