Medical Biller

VICTORY HEMATOLOGY AND ONCOLOGY INC; California (MO); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

401(k)

Dental insurance

Health insurance

Paid time off

Job summary

Victory Hematology and Oncology in Sherman Oaks, CA is seeking a Medical Billing Specialist to manage insurance billing, coding, and denials handling. You will collaborate with physicians, case managers, and insurers to ensure accurate coding, timely claims, and compliant processes.

The role requires strong communication, meticulous billing work, and the ability to educate clinical staff on coding practices, ensuring patient and payer satisfaction.

Qualifications

• Understanding of medical billing, including EOBs, ICD-10 and CPT coding.
• Working knowledge of appeals and denials processes for Medicare, Medi-Cal and other insurances.
• Ensure compliance and quality requirements are met.

Responsibilities

• Professional communication speaking and writing skills.
• Maintain HIPPA and OSHA compliance.
• Handle electronic billing and financial administration (budgets, billing, collections, payables, resubmissions, appeals, posting payments).
• Maintain current CPT, HCPCS and ICD coding knowledge and proper modifier/NCCI usage.
• Verify insurance eligibility and pre-authorizations; assist with authorizations.
• Gather and organize data from physicians and hospitals to determine billing codes and rates.
• Submit claims to third-party payers accurately and post payments.
• Communicate with service providers, clients, and staff regarding billing issues.
• Experience with billing processes including charge entry, payment posting and claim follow-up; knowledge of Medicare, HMO, IPAs, PPOs.
• Collaborate with clinical staff and credentialing/accreditation tasks.
• Assist in training and counseling staff on billing issues; resolve patient complaints following policies.

Skills

Medical billing

ICD-10 CPT coding

Insurance billing

Appeals & denials

HIPAA compliance

Customer service

Communication skills

Job description

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. In this role, you will maintain a solid rapport with all our clients (case managers and physicians) as well as the referring entities, (IPA, medical facilities, and insurance companies). 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

We are an equal opportunity employer.

Job Types

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)