Medical Billing Specialist

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision.

Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.

Job Description:

Role Summary

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.

Responsibilities

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.

Key Competencies

Attendance is an essential job function to maintain productivity and meet goals.

Posses 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.

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

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