Billing Specialist

Billing Specialist

The Billing Specialist is responsible for performing day-to-day billing activities for Urology, Radiation Oncology and Imaging services. This role focuses on accurate claim preparation, submission, and follow-up to ensure timely reimbursement, reduced denials, and compliance with payer requirements.

Responsibilities / Essential Functions

• Prepare, review, and submit clean claims for Urology, Radiation Oncology and Imaging services.
• Research, correct, and resubmit rejected or denied claims.
• Verify authorizations, referrals, and provider credentials prior to submission.
• Apply payer-specific billing rules, LCDs/NCDs, and medical policies.
• Maintain accurate documentation of billing activity and any payer communications.
• Respond to inquiries from payers, patients, and internal teams professionally and timely.
• Collaborate with coders, providers, and leads to resolve discrepancies.
• Maintain daily productivity and quality standards.

Specialty Knowledge & Compliance

• Working knowledge of CPT, ICD-10-CM, and HCPCS coding related to Urology, Radiation Oncology and Imaging services.
• Understanding of Medicare, Medicaid, and managed care billing requirements.
• Awareness of documentation and authorization requirements for specialty services.
• Adherence to SOPs, compliance guidelines, and payer regulations.

Tools & Systems

• Utilize billing systems, clearinghouses, and payer portals to submit and track claims.
• Reference internal tools and payer resources to support clean claim submission.

Qualifications

• 2+ years of medical billing experience preferred.
• Experience billing for Urology, Radiation Oncology and Imaging services strongly preferred.
• Knowledge of insurance reimbursement processes and payer rules.
• High school diploma or GED required; additional billing education preferred.

Preferred Skills & Competencies

• Strong attention to detail and accuracy.
• Effective time management and organizational skills.
• Ability to work independently in a fast-paced environment.
• Strong written and verbal communication skills.