Billing Specialist - Radiation Oncology - Hopewell - Full-Time - DAYS

Capital Health•Hopewell, NJ

2d•Onsite

About The Position

Capital Health is seeking a Billing Specialist for Radiation Oncology at Hopewell. This is a full-time position with day shifts. The Billing Specialist will be responsible for reviewing, updating, correcting, and approving daily case charges in the billing system, entering medical, hospital, and facility charges, and ensuring their accuracy for proper reimbursement. This role involves collaborating with nurses, assisting with insurance pre-authorizations, developing tracking spreadsheets, coordinating peer-to-peer authorization processes, and acting as a resource for coding and billing issues. The specialist will also follow up with outside departments, verify supply charges, revise billing discrepancies, and work with other departments on billing-related issues. Additionally, the role includes assigning codes accurately, applying special codes for specific procedures, manually charging post cap prices, discussing medical record information with physicians, obtaining missing documentation, and assisting other departments with the appeals process. The position also involves tracking medical records requests and preparing reports on medical records for claim satisfaction to increase revenue.

Requirements

High school diploma or GED.
Two years of medical insurance, insurance preauthorization, billing, or coding experience.
Intermediate experience with billing.
Familiarity with insurance language.
Basic computer skills.
Understanding of ICD-9 and CPT coding classifications.
Thorough knowledge of medical terminology, anatomy, and physiology.
Strong interpersonal skills.
Able to interact with insurance companies and physicians.
Works well in team settings.
Excellent organizational skills.
Excellent follow-up skills.

Nice To Haves

Previous hospital billing experience preferred.
Basic understanding of coding preferred.

Responsibilities

Reviews, updates, corrects, and approves daily all case charges from sites within the billing system.
Enters all medical and hospital charges, and other facility charges into the billing system.
Assures accuracy of these charges and poses them electronically.
Verifies in billing System that all charges for supplies, rooms, and other medical expenditures and assures their correct and accurate entry for proper reimbursement.
Runs daily reports for cases and documents to validate accurate charges.
Collaborates daily with nurses to add, change, update charges or documentation.
Assists in obtaining insurance pre-authorizations for patient consults, exams, treatments, imaging for patients being treated.
Assists in follow-up process for pending authorizations by providing necessary answers to questions from others or clinical documentation.
Develops spreadsheet to track pre-authorizations and treatment codes to ensure compliance with current treatment plan.
Coordinates peer to peer authorization process when authorizations are denied.
Obtains base prices as needed for specific charges and manually enters them into the billing system.
Acts as a resource for the department on any issues related to coding and billing.
Follows up daily with outside departments on any issues, clarification, questions, or updates to ensure billing accuracy.
Verifies against final patient orders and other documentation that all supply charges have been received.
Revises and corrects any billing discrepancies provided by the billing department.
Works collaboratively with other departments for billing related issues, pricing, coding, billing, and recalls.
Assigns codes with accuracy rate in accordance with coding guidelines.
Applies special codes (charge post) to certain procedures (cap pricing) for correct billing.
Manually charges post the cap price CDM for all required from a capped price agreement.
Discusses medical record information with physicians when necessary in accordance with coding guidelines.
Contacts physicians or other staff to obtain missing documentation or signatures timely.
Assists Medical Records, Compliance, and Finance Departments with appeals process by providing necessary documentation.
Tracks medical records requests from Patient Account Department billers and reviews to ensure compliance.
Prepares and communicates to appropriate parties on medical records reports and overdue medical records for purpose of satisfying claims to increase revenue.
Performs other duties as assigned.