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:

The Medical Billing Specialist is responsible for all aspects of charge capture including accurate entry of charges, timely charge posting and charge audits. The individual will need to have expertise in medical coding and insurance billing as well as a strong understanding of insurance reimbursement processes and regulations. The successful candidate will work closely with RCM leadership, patients, physicians, and insurance companies to ensure that accurate and timely billing is completed.

Responsibilities

• Run and audit various reports to ensure all required billing information has been received and is accurate

• Audit hospital charges and communicate outstanding charges and/or questions with clinical staff.

• Review and enter Imaging charges into practice management system

• Review and enter Pathology/Molecular charges into practice management system

• Review and enter Radiation Oncology charges into practice management system

• Create daily charge file from lab software to ensure proper charge capture

• Reconcile scheduled appointments to ensure accurate charge capture and communicate outstanding billing issues with clinical staff and/or providers when applicable

• Audit all charges from interfaced files to ensure accurate charge capture

• Communicate openly with Clinical staff and RCM teams 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 any tasks identified by ACE 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 when assigned by management

• Work together as a team with other staff to ensure charges are entered 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

• Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer.

Essential Competencies:

• Attendance is an essential job function.

• Detailed knowledge of billing, HCPCS, CPT and ICD codes

• Previous Charge Entry/Billing experience preferred

• 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)

• Ability to operate various types of office equipment.

• Must possess high degree of professionalism and adaptability.

Required Qualifications

• High School diploma or equivalent required

• Previous experience in Charge Entry, Billing or Coding required, preferably in an Oncology healthcare setting

• Radiation Oncology/Proton experience a plus

• Expertise in insurance policies and regulations related to medical billing, including Medicare and Medicaid