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. This values-driven culture reflects startup enthusiasm supported by industry leaders in oncology, technology, and finance.
The Medical Coding and Billing Specialist is responsible for writing and maintaining coding and billing rules in the practice management system, reviewing and importing daily charges in Radiology Authorization Specialist, and daily claim filing under team manager supervision.
Responsibilities include reviewing and verifying patient insurance coverage for proton therapy, radiation therapy, and radiology services, ensuring charges are entered timely and accurately, generating and submitting claims, monitoring claims payment, resolving claim rejections and denials, interpreting insurance policies for compliance, collaborating with medical and pre-authorization teams, maintaining billing records, reviewing oncology medical records for coding accuracy, educating clinical staff on documentation, responding to inquiries, staying current on industry trends, managing charge statuses, creating and maintaining ACE rules, filing claims, communicating with leadership to ensure coding compliance, and supporting the mission to improve cancer patient lives.
Qualifications require a bachelor's degree preferred, minimum two years of charge entry/billing experience, 1+ year prior authorization experience, knowledge of CPT, HCPCS, ICD-9 coding, proficiency in Microsoft Excel, medical insurance background, and expertise in Medicare and Medicaid billing policies.
Competencies include attendance, effective communication across management levels, professionalism, adaptability, proficiency in computer applications and medical information systems, strong customer service skills, problem-solving abilities, attention to detail, and knowledge of hospice and payer requirements, medical terminology, and clinic office procedures.
- Bachelor's degree preferred
- Minimum 2 years experience in charge entry/billing
- 1+ year prior authorization experience
- Extensive knowledge of CPT, HCPCS, ICD-9 coding and insurance billing guidelines
- Medical insurance background, including Medicare and Medicaid expertise
- Proficiency in Microsoft Excel and strong computer skills
- Knowledge of hospice and payer requirements
- Skilled in medical terminology and clinic office procedures
- Strong communication, organizational, multi-tasking, and problem-solving skills
- Professionalism, initiative, and adaptability
- Ability to work with all management levels and teams
Location
N/A
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago