Certified Medical Biller

Job Description

Job Description

Benefits :

401(k)

401(k) matching

Dental insurance

Health insurance

Paid time off

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

For considerations, please remit your resume. We are an equal opportunity employer.

Principals only. Recruiters, please don't contact this job poster. Do NOT contact us with unsolicited services or offers

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)

Work Location : In person