Billing Specialist

About the role

The US Oncology Network is looking for a Billing Specialist to join our team at Texas Oncology. This full-time remote position will support the Medical Oncology-Charge Entry Department at our 3001 E. President George Bush Highway Suite 100 location in Richardson, Texas. Typical work week is Monday through Friday, 8:00 a.m. – 5:00 p.m.

This Billing Specialist position will support our Charge Entry Department for the Central Business Office and play a vital role in helping ensure accurate and timely revenue cycle processes. This position can be a level 1, 2 or Sr based on relevant candidate experience.

As a part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas. Our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today—at Texas Oncology, we use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve “More breakthroughs. More victories.”® in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis.

Responsibilities

• Under direct supervision is responsible for all claim submissions, which includes verifying accuracy of charges and patient demographic information on claim detail.
• Responsible for timely follow-up with patients and third party payors.
• Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.
• Collects and reviews all patient insurance information needed to complete the billing process.
• Completes all necessary insurance forms (i.e. HCFA 1500, Blue Cross/Blue Shield, UMWA, Medical Assistance, Medicare, etc.) to process the proper billing information in a timely manner as required by all third party payors.
• Transmits daily all electronic claims to third party payors.
• Researches and resolves any electronic claim delays within 24 hours of exception report print date.
• Submits all paper claims and supporting documentation as required by payors.
• Files all claims, documentation, etc. in patient financial files.
• Resolves patient complaints and requests regarding insurance billing and initiates accurate account adjustment. Follows all billing problems to conclusion.
• Resubmits insurance claims as required.
• Reports any trends/delays to supervisor.
• Processes any necessary insurance/patient correspondence.
• Mails accurate statements to patients within 24 hours of print date.
• Provides all necessary documentation (on or with HCFA1500) required to expedite payments. This includes demographic, authorization/referrals, UPIN number, and referring doctors.
• Submits claims within 24 hours of print date.
• Obtains appropriate medical records, with patient and/or responsible party authorization on file, as they relate to the billing process.
• Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation.
• Communicates effectively to payors and/or claims clearinghouse to ensure accurate and timely electronically filed claims as per department guidelines.

Qualifications

• Level 1 – High school graduate or equivalent. This position is entry level and requires 0–3 years experience in a medical business office setting.
• Level 2 – In addition to level 1 requirements, minimum three years experience in a medical business office setting.
• Level Sr – In addition to level 1 and 2 requirements, minimum five years experience in a medical business office setting.

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.

• Work may require sitting for long periods of time; also stooping, bending and stretching for files and supplies.
• Occasionally lifting files or paper weighing up to 30 pounds.
• Requires manual dexterity sufficient to operate a keyboard, a calculator, telephone, copier and other such office equipment.
• Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts.
• It is necessary to view and type on computer screens for prolonged periods of time.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Work is performed in an office environment.
• Involves frequent interaction with staff, patients and the public.