Medical Biller/Coder

Job Summary

Our Hematology-Oncology practice is seeking a detail-oriented and knowledgeable full-time Medical Biller to join our growing Billing Team. The ideal candidate will have, at least, 1-2 years of hands-on experience in the field. Hematology/Oncology/Infusion billing experience is strongly preferred.

Responsibilities

• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Reviews Hematology/Oncology patient medical records and abstracts medical data to accurately capture all diagnoses, procedures, and appropriate modifiers from the medical record documentation using ICD-10-CM, CPT4/HCPCS classification systems.
• Evaluates medical documentation and determines accurate E/M levels.
• Ensures that CPT and ICD-10 codes are aligned so that there will be no question as to the relationship between diagnosis and treatment, and the claim will be reimbursed.
• Ensures that professional services are captured and coded in compliance with federal regulations and insurance requirements.
• Affirms encounter documentation using Center for Medicare and Medicaid Services (CMS) documentation standards. Based on the provider's documentation, identifies possible documentation changes that would more accurately account for services provided if implemented. Presents findings to management and works to resolve the issue.
• Follows all regulations and guidelines set by Medicare, state programs, and HMO/PPO.
• Correctly enters coding information into CureMD’s electronic medical record system. Ensures patient information is accurate and complete.
• Identifies and bills secondary or tertiary insurances. Requests any missing patient information.
• Transfers insurance claims and billing data to billing software.
• Ability to create both paper and electronic copies of documentation.
• Responds to questions and complaints from patients or insurance companies.
• Updates and reviews all accounts to keep records of payments up to date.
• Works with personal information and maintains patient confidentiality.
• Obtains referrals and pre-authorizations as required for procedures. Checks eligibility and benefits verification for treatments and procedures. Reviews patient bills for accuracy and completeness and obtains any missing information.
• Following up on unpaid claims within the standard billing cycle timeframe. Calls insurance companies regarding any discrepancies in payments if necessary.
• Researches and appeals denied claims.
• Answers all patient or insurance telephone inquiries pertaining to assigned accounts.
• Keeps up to date on billing/coding rules, including the annual update of CPT-4 and ICD-10 codes. Maintains CEU’s needed for certification.

Requirements

• Certification REQUIRED: AAPC or AHIHMA - CPB, CPC, CHONC
• 1-2 years of hands-on medical billing experience in a medical office or healthcare setting
• Hematology/Oncology/Infusion Billing Experience is STRONGLY PREFERRED
• 1-2 years of hands-on experience using medical billing software and electronic health record systems
• Able to multitask, prioritize, and manage time efficiently
• Self-motivated and self-directed; able to work without supervision
• Excellent verbal and written communication skills
• Proficient computer skills, Microsoft Excel
• Strong customer service skills and comfortable answering both patient and insurance company questions
• Able to analyze problems and strategize for better solutions