Billing Specialist

Overview Employment Type: Full Time REMOTE Benefits: M/D/V, Life Ins., 401(k) Pay Range: $21.00 - $28.00 based on experience SCOPE: Under general 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 non-routine patient billing inquiries and problems. 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 US Oncology's 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 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 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 patient’s records and collections. Responsible for maintaining current billing, coding, and standard operating procedures (SOP) files as a desk reference. Other duties as requested or assigned. May perform payment responsibilities. Qualifications MINIMUM QUALIFICATIONS High school diploma or equivalent required. Minimum of two (2) years medical billing and payment specialist or equivalent experience required. Medical coding experience 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. COMPETENCIES Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; accesses and uses other expert resources when appropriate. Demonstrates Adaptability : Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility. -Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty. Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them. Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies. 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 accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is primarily required to remain in a stationary position for extended periods of time, operate a computer and other standard office equipment, communicate effectively via telephone and virtual platforms, and occasionally move within the home workspace. Vision, hearing, and manual dexterity sufficient to perform keyboarding and screen-based work are required. WORK ENVIRONMENT This is a fully remote position. The work environment is a home-based office setting. Work is performed primarily using a computer, telephone, and other remote collaboration tools. The role involves frequent virtual interaction with coworkers, leaders, and internal or external stakeholders. MINIMUM QUALIFICATIONS High school diploma or equivalent required. Minimum of two (2) years medical billing and payment specialist or equivalent experience required. Medical coding experience 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. COMPETENCIES Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; accesses and uses other expert resources when appropriate. Demonstrates Adaptability : Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility. -Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty. Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them. Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies. 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 accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is primarily required to remain in a stationary position for extended periods of time, operate a computer and other standard office equipment, communicate effectively via telephone and virtual platforms, and occasionally move within the home workspace. Vision, hearing, and manual dexterity sufficient to perform keyboarding and screen-based work are required. WORK ENVIRONMENT This is a fully remote position. The work environment is a home-based office setting. Work is performed primarily using a computer, telephone, and other remote collaboration tools. The role involves frequent virtual interaction with coworkers, leaders, and internal or external stakeholders. 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 patient’s records and collections. Responsible for maintaining current billing, coding, and standard operating procedures (SOP) files as a desk reference. Other duties as requested or assigned. May perform payment responsibilities. #J-18808-Ljbffr