What are the responsibilities and job description for the Medical Billing Specialist position at Regional Business Office?
Overview :
Employment Type : Full Time
In-Office Position
Benefits : M / D / V, Life Ins., 401(k)
Evansville, IN
JOB SCOPE : With minimal supervision, prepares and submits patient claims to appropriate third party payers. Reviews claims to ensure that payer specific billing requirements are met. Resolves routine and complex patient billing inquiries and problems. Relies on extensive experience and judgment to plan and accomplish goals. A certain degree of creativity and latitude is required. Follows standard procedures and pre-established guidelines to complete tasks. Supports and adheres to The US Oncology Compliance Program, to include the Code of Ethics and Business Standards, and The US Oncologys Shared Values.
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 nations 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.
Responsibilities :
ESSENTIAL DUTIES AND RESPONSIBILITIES :
- Collects patient documentation and charts for claim submission. Ensures claim forms are completely and accurately filled out.
- Updates and maintains patient billing data and ensures documents are current.
- Reviews patient charts for completeness. Contacts clinical staff for clarification on procedures or diagnosis and on missing information.
- Enters charges, processes, and submits insurance claims to third party payer. Completes data entry of the charges into Practice Management System.
- Completes review of interface transactions and resolution of TES edits.
- Verifies that initial claim is accepted by third party payers. Reviews reports for claim denials.
- Identifies and reports any payer trends, denial patterns, and delays to management. -Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patients records and collections.
- Responsible for maintaining current billing, coding, and SOP files as a desk reference.
- Trains new coworkers on policies and procedures.
- Double checks co-workers work and provides procedure guidance.
- May research, resolve, or provide direction on co-workers escalated issues.
- Proactively identifies processes and procedures and develops tools to improve efficiencies.
- Other duties as requested or assigned. May perform payment responsibilities.
Qualifications :
Minimum Qualifications :
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.
