Medical Billing Specialist - Regional Business Office

Employment Type: Full Time

In-Office Position

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

Norfolk, Virginia

Pay Range: $18-$22 Hourly 

JOB SCOPE: Under minimal supervision is responsible for all claim submissions, which includes verifying accuracy of charges and patient demographic information on claim detail. Responsible for timely follow-up with patients and third party payors. May orient, train, and assign the work of lower level employees. May be designated as the lead employee. Supports and adheres to The US Oncology Compliance Program, to include the Code of Ethics and Business Standards.

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.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Collects and reviews all patient insurance information needed to complete the billing process.
• Completes all necessary insurance forms (i.e. HCFA 1500, Blue Cross/Blue Shield, UMWA, Medical Assistance, Medicare, etc.) to process the proper billing information in a timely manner as required by all third party payors.
• Transmits daily all electronic claims to third party payors. Researches and resolves any electronic claim delays within 24 hours of exception report print date.
• Submits all paper claims and supporting documentation as required by payors. Files all claims, documentation, etc. in patient financial files.
• Resolves patient complaints and requests regarding insurance billing and initiates accurate account adjustment.
• Follows all billing problems to conclusion.
• Resubmits insurance claims as required.
• Reports any trends/delays to supervisor.
• Processes any necessary insurance/patient correspondence.
• Mails accurate statements to patients within 24 hours of print date.
• Provides all necessary documentation (on or with HCFA1500) required to expedite payments. This includes demographic, authorization/referrals, UPIN number, and referring doctors. Submits claims within 24 hours of print date.
• Obtains appropriate medical records with patient and/or responsible party authorization on file as they relate to the billing process.
• Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation.
• Communicates effectively to payors and/or claims clearinghouse to ensure accurate and timely electronically filed claims.
• May provide guidance and daily work direction to junior level staff.

MINIMUM QUALIFICATIONS:

• High school diploma or equivalent required. Associates degree in Finance, Business or four years revenue cycle experience preferred.
• Minimum of four (4) years medical billing and payment specialist or equivalent experience required.
• Medical coding experience preferred. Certified Professional Coder certification preferred.
• 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.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear.  Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination.  Requires standing and walking for extensive periods of time.  Occasionally lifts and carries items weighing up to 40 lbs.  Requires corrected vision and hearing to normal range.

WORK ENVIRONMENT: The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment.  Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.