Senior Oncology Billing Lead - Complex Claims & Appeals

HealthCare Recruiters International; Visalia (CA); On-site; USD 88,828,000 - 108,886,000; Full time

Benefits offered by this job

PTO 16 days

Paid holidays 12

Insurance (medical, dental, vision)

401(k)

Life & long-term disability insurance

Dependent care benefits

Job summary

HealthCare Recruiters International is seeking an experienced Senior Oncology Billing Specialist to support a busy oncology practice in Visalia, CA. This role is responsible for managing complex oncology billing functions, including insurance verification, prior authorizations, coding, claims, denials, appeals, payment reconciliation, and collections.

Responsibilities include insurance eligibility checks, prior authorizations for chemotherapy, coding with CPT/ICD-10-CM/J-codes, submitting claims

Qualifications

• 3 years of experience in medical billing, coding, collections, or revenue cycle management.
• Strong knowledge of insurance claims, reimbursement, EOBs, denials, and appeals.
• 3 years of experience with medical billing systems, EHR/EMR platforms, and payer portals.

Responsibilities

• Verify insurance eligibility, benefits, and oncology treatment coverage.
• Obtain prior authorizations for chemotherapy, infusion therapy, and high-cost treatments.
• Review and code oncology services using CPT, ICD-10-CM, HCPCS, J-codes, and modifiers.
• Submit accurate claims to commercial payers, Medicare, Medicaid, and other insurers.
• Review EOBs, post payments, identify underpayments, and correct denials.
• Research denials and prepare payer appeals with supporting documentation.
• Review accounts for missed charges, unbilled services, and reimbursement issues.
• Manage outstanding insurance and patient balances.
• Work with staff to resolve billing, coding, documentation, and authorization issues.
• Maintain HIPAA and healthcare billing compliance.

Skills

Medical billing & coding

Revenue cycle management

Payer portals

Tools

EHR/EMR systems

Payer portals

Billing software

Job description

HealthCare Recruiters International is seeking an experienced Senior Oncology Billing Specialist to support a busy oncology practice in Visalia, CA. This role is responsible for managing complex oncology billing functions, including insurance verification, prior authorizations, coding, claims, denials, appeals, payment reconciliation, and collections.

Responsibilities include insurance eligibility checks, prior authorizations for chemotherapy, coding with CPT/ICD-10-CM/J-codes, submitting claims