[Hiring] Medical Billing Specialist @OneOncology

Role Description

The Medical Billing Specialist works under the direct supervision of the Director, Billing and AR. Responsibilities include all aspects of charge capture for Medical Oncology which entails accurate & timely entry and review of charges as well as charge auditing. The successful candidate will need to have expertise in medical coding and insurance billing as well as a strong understanding of insurance reimbursement processes and regulations.

• Review, audit and manipulate charges from interfaced files to ensure timely and accurate charge capture for billing.
• Audit/manually enter Pathology/Molecular, Psychology, Genetic Counseling and other charges into practice management system and communicate outstanding charges and/or questions with clinical staff.
• Run and audit various reports to ensure all required billing information has been received and is accurately captured in practice management system.
• Create daily charge file from lab application software to ensure proper charge capture.
• Reconcile scheduled appointments to ensure charge capture and communicate outstanding billing issues with clinical staff and/or providers when applicable.
• Communicate openly with Clinical staff and RCM teams in a collaborative manner to ensure timely and accurate charge posting.
• Review medical records as needed to ensure coding accuracy which includes diagnosis, procedures, and modifiers.
• Work assigned Unity tasks daily to resolve items identified by ACE claim edits, rejections, denials, collectors or other RCM teams.
• Identify and work tickets to resolution in various statuses within the Practice Management system daily.
• Ability to review, interpret and apply knowledge of billing guidelines and medical policies.
• Train with team members or other employees to enhance personal knowledge and abilities, when assigned by management.
• Ability to work autonomously and have a team-oriented, collaborative mindset to ensure charges are captured timely and accurately.
• Maintains a complete understanding of HCPCS/ICD/CPT Oncology coding and specific carrier requirements/knowledge.
• Follows policy and procedures outlined by management to ensure standardization of processes.
• Other duties as assigned to help drive our mission of improving the lives of everyone living with cancer.

Qualifications

• High School diploma or equivalent required.
• Previous experience in Charge Entry, Billing or Coding required, preferably in an Oncology Healthcare setting.
• Expertise in insurance policies and regulations related to medical billing, including Medicare, Medicaid and commercial plans.

Requirements

• Attendance is an essential job function to maintain productivity and meet goals.
• Possess detailed knowledge of billing, HCPCS, CPT and ICD codes.
• Ability to work effectively with all levels of management and other colleagues, demonstrating initiative, mature judgment and customer service orientation.
• Effective verbal and written communications, including active listening skills and skill in presenting findings and recommendations.
• Exceptional multi-tasking, organizational skills and superb attention to detail.
• Strong analytical skills and ability to meet assigned deadlines.
• Strong knowledge of Windows-based applications (Word, Outlook, Excel, etc).
• Must possess high degree of professionalism and adaptability.

Company Description