The Billing Coordinator is responsible for all front end technical and professional billing procedures. Provides education to staff and physician education concerning compliant and comprehensive charge capture. Performs daily review of charge export. Performs adjudication of charges and responds to ProCures billing agency assigned edits. Provides analysis and response to performance reports. Performs billing entry / export for/to the professional component billing agency, hospital billing system and ProCures billing agency. The Billing Coordinator is also responsible for reviewing demographic, employment and insurance data necessary for payment for radiation therapy treatment and verifies insurance coverage and benefits of our patients. The Billing Coordinator may be asked to perform financial screening, making financial arrangements and advise self-pay patients on alternative ways to meet their financial obligation, including but not limited to financial hardship screening and payment plans.
Review all charges prior to export to ProCures billing agency and CDHs hospital billing system to ensure completeness of demographics, insurance information compliant and comprehensive charge capture with supporting documentation
Responsible for data entry to ROCLs billing agency after review of all charges
Responsible for review and appeal of professional claims as they relate to all professional and technical radiation therapy services performed by ROCL, ProCure & CDH
Responsible for daily monitoring and charging of Physician Quality Reporting Initiatives (PQRI)
Use Discrepancy Lists system within departments to prevent incorrect or incomplete charges
Works with ROCLs Business Manager, ProCures VP of Accounting and the CDH Billing office on cases of financial hardship
Serves as a contact to patients and patient families by providing basic information in response to inquiries and/or complaints regarding eligibility status /during treatment changes/concerns
Maintains expert, current knowledge regarding code-capture, applicability to the services provided and compliance for documentation and correct coding
Maintains current knowledge of all payer policies and procedures as they relate to radiation oncology billing; make, communicate and educate staff on changes
Understand and comply with charge master policies and procedures as established by the reimbursement contracts set forth by ROCL, ProCure and CDH
Exemplary customer satisfaction skills, including dealing effectively with the staff and the public, both in person and over the telephone
Skilled Word, Excel and Outlook user
Other duties as assigned by Managers
WORK EXPERIENCE REQUIREMENTS
Experience in healthcare billing/registration/accounting and overall patient financial counseling.
Knowledge of medical CPT and ICD-9 experience, code capture through invoice preparation.
Experience in Radiation Oncology preferred.
Experience in an Electronic Medical Record format.
REQUIRED SKILLS AND ABILITIES
Organizing own work, coordinating projects, setting priorities, meeting deadlines and following up on assignments with a minimum of direction.
Using initiative and independent judgment within established policy and procedural guidelines.
Communicating effectively with co-workers, Managers, partner hospitals/medical practices, the general public, representatives of public and private organizations and others sufficient to exchange or convey information.
Problem Solving/Analytical Skills
Organization, Attention to Detail & Time Usage
Performance Standards/Results Orientation
Interpersonal / Communication skills
HS Diploma required
Certified Medical Coder or equivalent experience
ProCure utilizes RFID (Radio-Frequency Identification) tags at the centers for the purposes of analysis of productivity and patient throughput. This information is not for use as a management tool for employee performance issues.
Job may involve occasional travel to ROCLs business office, ProCures Training and Development Center for orientation and annual training, as well as travel to other network centers for conferences from time to time