Medical Biller

VICTORY HEMATOLOGY AND ONCOLOGY INC; California; On-site; USD 55,000 - 70,000; Full time

Benefits offered by this job

401(k)

Dental insurance

Health insurance

Paid time off

Job summary

Victory Hematology and Oncology has a Medical Billing Specialist position in Sherman Oaks, California. The role handles insurance billing, coding, denials appeals, and daily billing operations for a hematology/oncology practice.

The candidate will ensure HIPAA compliance, communicate with insurers and patients, and work as a key liaison with referring clients, while maintaining accurate coding and timely claim submissions.

Qualifications

• Excellent understanding of medical billing including insurance billing and payments processing (EOBs).
• Strong knowledge of Medicare, Medi-Cal and other commercial insurances appeals/denials.
• Ensure compliance and quality requirements are met.
• Communicate billing issues with insurance companies, clinical staff and patients.
• Main link between facility and referring clients; requires excellent customer service.

Responsibilities

• Professional communication speaking and writing skills.
• Maintain HIPAA compliance.
• Handle billing, collections, payables, resubmissions, appeals and posting payments.
• Maintain CPT, HCPCS and ICD coding accuracy including modifiers and NCCI edits.
• Collect insurance information, verify eligibility and obtain pre-authorizations.
• Assist clinical staff with pre-authorizations.
• Gather data from physicians and hospitals to determine billing codes and rates.
• Verify codes submitted to payers match services rendered.
• Submit claims accurately and timely; post codes to patient accounts.
• Collaborate effectively with service providers and clients.
• Experience in charge entry, payment posting and claim follow-up with Medicare/HMO/PPO.
• Knowledge of medical terminology, pharmacology and anatomy.
• Administrative duties related to credentialing and clinic billing operations.
• Train clinical staff on billing issues and work as a team.
• Handle patient complaints per policies.

Skills

Medical billing

ICD-10 CPT coding

Insurance appeals/denials

Communicate with insurers and staff

Customer service skills

Job description

Job Description

Victory Hematology and Oncology has a Medical Billing Specialist position available for a well-organized and knowledgeable Medical Billing and Coding Specialist with a Hematology and Oncology practice in Sherman Oaks, California.

Qualifications

• The successful candidate must have an excellent understanding of medical billing, which includes Insurance billing and payments processing: EOBs, ICD-10 and CPT coding.
• Candidates must have a strong understanding and working knowledge of the appeals and denials processes for Medicare, Medi-Cal and other commercial health insurances.
• Candidate is going to ensure all compliance and quality requirements are met.
• Candidate can efficiently communicate insurance company, clinical staffs and patients regarding billing issues.
• In addition, this position is the main link between our facility and our referring clients. Therefore, excellent customer service skills are a requirement

Major duties and responsibilities

• Professional communication speaking and writing skills
• Maintains HIPPA and OSHA compliance
• Strong knowledge of electronic billing and financial administration to handle budgets and billing, collections, payables, resubmissions, appeals, and posting payment.
• Maintaining current knowledge of CPT, HCPCS and ICD, coding systems (including ICD 10), including the appropriate application of procedure code modifiers and NCCI edits
• Collect insurance information, verify patient's insurance eligibility, and pre-authorizations.
• Assist with clinical staff for pre-authorizations.
• Gathering and organizing all necessary data from physicians, hospitals and/or ancillary personnel, determining billing codes and calculating rates.
• Verifying that CPT, HCPCS and ICD-9 (ICD-10) codes submitted to third-party payers are an accurate representation of the home health care services rendered by the provider(s).
• Ensure accurate and timely submission of claims submitted to third-party payers. Posting coded services to the appropriate patient account(s) in the software system.
• Maintain effectively communicate with service providers, clients, and other ancillary personnel
• Has experience in medical billing processes including charge entry, payment posting and claim follow-up and extensive knowledge of Medicare, HMO, local IPAs, and PPO carriers
• Has advanced understanding of medical terminology, pharmacology, body systems/anatomy
• Administrative duties related to credentialing and/or accreditation
• Administrative operations of the clinic at billing related issues, training, and counseling clinical staff regarding billing related issues.
• Effectively work with clinical staffs as a team
• Ability to continue education at work and learn from senior billing specialists and other clinal staffs.
• Handles and resolves patients' complaints/grievance as per policies and procedures

Job Types: Full-time

Job Type: Full-time

Benefits

• 401(k)
• Dental insurance
• Health insurance
• Paid time off

Ability to Commute

• Sherman Oaks, CA 91403 (Required)

Ability to Relocate

• Sherman Oaks, CA 91403: Relocate before starting work (Required)

We are an equal opportunity employer.