[Hiring] Billing Specialist @The US Oncology Network

Role Description

We are seeking a Billing Specialist to join our team in a remote role, candidates must be located in Southern Nevada.

SCOPE:

Under general supervision, prepares and submits patient claims to appropriate third party payers. Reviews claims to ensure that payer specific billing requirements are met. Resolves routine and non-routine patient billing inquiries and problems. Follows standard procedures and pre-established guidelines to complete tasks. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards, and US Oncology’s Shared Values.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Collects patient documentation and charts for claim submission.
• Ensures claim forms are completely and accurately filled out.
• Updates and maintains patient billing data and ensures documents are current.
• Reviews patient charts for completeness.
• Contacts clinical staff for clarification on procedures or diagnosis and on missing information.
• Enters charges, processes, and submits insurance claims to third party payer.
• Completes data entry of the charges into Practice Management System.
• Completes review of interface transactions and resolution of TES edits.
• Verifies that initial claim is accepted by third party payers.
• Reviews reports for claim denials.
• Identifies and reports any payer trends, denial patterns, and delays to management.
• Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient records and collections.
• Responsible for maintaining current billing, coding, and standard operating procedures (SOP) files as a desk reference.
• Other duties as requested or assigned. May perform payment responsibilities.

Qualifications

• High school diploma or equivalent required.
• Minimum of two (2) years medical billing and payment specialist or equivalent experience required.
• Medical coding experience preferred.
• Proficiency with computer systems and Microsoft Office (Word and Excel) required.
• Working knowledge of state, federal, and third-party claims processing required.
• Must successfully complete required e-learning courses within 90 days of occupying position.

Requirements

• Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; accesses and uses other expert resources when appropriate.
• Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience in the face of constraints, frustrations, or adversity; demonstrates flexibility.
• Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty.
• Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them.
• Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluates products, processes, and service against those standards; manages quality; improves efficiencies.

Benefits

• Excellent benefits.
• Team environment.
• Professional development.
• Chance to be part of a nationwide network dedicated to fight the war against cancer.