Medical Billing Specialist

OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. 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, 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 community oncologists and the patients they serve.

Job Description :

The Medical Billing Specialist works under the direct supervision of the Medical Billing Manager. 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
• Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer.

Essential Competencies :

presenting findings and recommendations

Required Qualifications :

Preferably in an Oncology Healthcare setting)

Medicaid and commercial plans

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