OneOncology is a patient-centric, physician-driven oncology organization focused on improving cancer care through technology-powered models. The Medical Coding and Billing Specialist is responsible for developing and maintaining coding and billing rules in the practice management system, reviewing daily charges, and managing claims related to proton therapy, radiation therapy, and radiology services.

Key responsibilities include verifying patient insurance coverage, ensuring timely and accurate charge entry, generating and submitting claims, tracking claim payments, handling denials and appeals, collaborating with pre-authorization teams, maintaining accurate billing records, educating clinical staff on documentation requirements, and staying current with coding regulations and insurance policies. The role also involves daily review of charge statuses, creating and maintaining editing rules to reduce denials, and communicating effectively with practice leadership.

Applicants should have a bachelor's degree preferred, with at least two years of charge entry/billing experience and over one year in prior authorization. Proficiency in CPT, HCPCS, ICD-9 coding, insurance billing guidelines, Microsoft Excel, and medical insurance policies including Medicare and Medicaid is required. Physical demands include occasional lifting up to 25 pounds and travel to satellite clinics.

Essential skills include professionalism, adaptability, strong customer service, problem-solving, organization, attention to detail, and knowledge of hospice and payer requirements.