Billing Specialist Sr.

Company: Comprehensive Cancer Centers of Nevada
Location: Norfolk
Posted on: May 20, 2023

Job Description:

Overview

Employment Type: Full Time

In-Office Position

Benefits: M/D/V, Life Ins., 401(k)

Norfolk, Virginia

JOB SCOPE: With minimal 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 complex patient billing inquiries and problems. Relies on extensive experience and judgment to plan and accomplish goals. A certain degree of creativity and latitude is required. 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.

The US Oncology Network is a thriving organization that fosters forward-thinking, advancement opportunities, and an inspired work environment. We continuously look for top talent who will continue to propel our organization in the right direction and celebrate new successes! Come join our team in the fight against cancer!

About US Oncology
The US Oncology Network is one of the nation's largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care. For more information, visit www.usoncology.com. We extend an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, Vision Plan, 401-K with a matching component, Life Insurance, Short-term and Long-term disability, and Wellness & Perks Programs.

Responsibilities

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's records and collections.
• Responsible for maintaining current billing, coding, and SOP files as a desk reference.
• Trains new coworkers on policies and procedures.
• Double checks co-workers work and provides procedure guidance.
• May research, resolve, or provide direction on co-workers escalated issues.
• Proactively identifies processes and procedures and develops tools to improve efficiencies.
• Other duties as requested or assigned. May perform payment responsibilities.
  Qualifications
  
  Minimum Qualifications:
  
  • High school diploma or equivalent required.
  • Two-Four years of medical billing and payment specialist or equivalent experience required.
  • Proficiency with computer systems and Microsoft Office (Word and Excel) required.
  • Working knowledgeable of state, federal, and third-party claims processing required
  • Must successfully complete required e-learning courses within 90 days of occupying position.

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