Patient Billing Specialist

Job Description

Job Description

About the Role:

We are seeking an experienced and detail-oriented Certified Medical Coder with Radiation Oncology experience to support accurate coding, billing, and compliance within our oncology practice. The successful candidate will review medical documentation and assign appropriate ICD-10-CM, CPT, and HCPCS codes for radiation oncology services while ensuring compliance with Medicare, commercial payer, and regulatory requirements. This position plays a critical role in optimizing reimbursement, reducing denials, and supporting the overall revenue cycle performance of the Radiation Oncology department. Training will be provided for qualified candidates with strong coding knowledge and a willingness to learn Radiation Oncology services.

Minimum Qualifications:

• High school diploma or equivalent required; associate degree or higher preferred.
• Minimum of 2 years experience in medical billing  or patient account management.
• Familiarity with medical billing software and electronic health record (EHR) systems.
• Strong understanding of insurance processes, including verification and claims submission.
• Excellent communication and customer service skills.

Preferred Qualifications:

• Certification in medical billing or coding (e.g., Certified Professional Biller - CPB).
• Experience working with multiple insurance providers and government programs such as Medicare and Medicaid.
• Knowledge of healthcare regulations such as HIPAA and compliance standards.
• Proficiency in advanced billing software and data analysis tools.
• Prior experience in a hospital or large healthcare facility environment.
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), RHIT, RHIA, or equivalent coding certification preferred. 

Responsibilities:

• Review and analyze medical records for accurate CPT code assignment on radiation therapy services. 
• Assign ICD-10-CM codes based on provider documentation. 

Ensure coding complies with federal, state, payer, and organizational guidelines. 

• Identify and communicate documentation deficiencies to providers when clarification is needed. 
• Assist with claim edits, denials, appeals, and coding audits. 
• Collaborate with physicians, physicists, dosimetrists, therapists, and revenue cycle staff regarding coding and documentation requirements.

Maintain productivity and accuracy standards. 

Stay current with coding updates, payer requirements, and regulatory changes.

• Performs other related department duties which may be inclusive but not listed in job description.