Billing Specialist

Posted 4 Days Ago
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Fresno, CA
Junior
Healthtech
The Role
The Billing Specialist is responsible for pre-submitting claims to insurance carriers, verifying diagnoses and medications, managing high volumes of claims, and maintaining compliance across multiple accounts while fostering quality relationships with patients and staff.
Summary Generated by Built In

Partnering With Physicians To Provide Best In Class Patient Care

Founded in 2002, Integrated Oncology Network is committed to helping our physicians deliver the right care, at the right time and in the right setting. We strongly believe that preserving the independent practice of medicine where patients are cared for closer to home and surrounded by our dedicated clinicians yields better outcomes. By creating a care continuum between our clinicians, patients and their support networks we deliver an unparalleled approach to the patient’s care journey.

Purpose: 

Responsible for scrubbing all claims pre-submission to the insurance carrier, verifying diagnosis, validating chemotherapy against the drug cabinet, and working on high-volume claims daily. Will work directly with the team to assist in other areas. The position performs complex duties requiring judgment and discretion, following established procedures and guidelines.

Responsibilities/Essential Functions:

  • Charge Capture and scrubbing of claims for multiple departments.
  • Validate all Clinical Service Lines for accuracy and guidelines (HCPCS, CPT, diagnosis, units, etc.)
  • High volume of daily claims to be submitted for a large organization.
  • Monitor multiple accounts and maintain compliance, with rules and regulations.
  • Maintain quality relationships with patients, managers, supervisors, and other office staff.

Complete their duties as assigned based on business operational needs.

Experience, Qualifications/Education:

  • Knowledge of insurance reimbursement procedures, CPT, ICD-10, and HCPCS codes, along with billing, and medical practice policies.
  • Preferred, one year of billing experience in a healthcare organization.
  • Preferred, knowledge of insurance carriers, DOFR, IPAs
  • Detailed-oriented candidate that can multi-task
  • High school diploma or equivalent required
  • College Education/Vocational Training in Medical Billing is preferred.
  • Preferred, one year of billing experience in a healthcare organization.
  • Knowledge of computer/telephony support, preferably in a healthcare environment
  • Strong customer service background, preferably in health care environment
  • Excellent verbal communication skills
  • Competence with computer processing functions and other standard office equipment
  • Ability to manage and prioritize multiple tasks
  • Ability to type 40+ wpm
  • Ability to calmly and professionally resolve customer issues with diplomacy and tact
  • Ability to work independently with minimal supervision
  • Strong organizational skills

Working Conditions:

  • This position functions primarily indoors in a medical / business environment. Employee may be subject to blood-borne pathogens, radiation, bio waste, and other medically related factors, with exposure to moderate noise levels.
  • Visual acuity to read and compute screen and paper documents; close and distance vision, peripheral vision depth perception, ability to adjust focus; hearing acuity to converse with staff and customers; ability to walk, stoop, bend, kneel, and lift and move 25 pounds on a regular basis; ability to sit for hours at a time. Employee will be exposed to moderate noise levels, interruptions, and occasionally asked to work evenings and weekends as needed.

Top Skills

Cpt
Hcpcs
Icd-10
The Company
Nashville, , Tennessee
190 Employees
On-site Workplace
Year Founded: 2008

What We Do

As a nationwide leader in oncology and urology programs, ION partners directly with physicians, hospitals and other health care providers to offer the latest oncology and urology technologies to their patients. ION has a network of 49 centers in 14 states, providing a complete and integrated continuum of care – diagnostic testing, radiation oncology, medical oncology, urology and ancillary services

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