Chemotherapy Revenue Reimbursement Specialist

CHEMOTHERAPY REVENUE REIMBURSEMENT SPECIALIST - FULL TIME

Join to apply for the CHEMOTHERAPY REVENUE REIMBURSEMENT SPECIALIST - FULL TIME role at Jump Start Games

Essential Functions

• Follow up on open claims in accordance with established guidelines. Review claims for completeness and compliance with billing guidelines.
• Work to resolution disputes and appeals of third-party denials. Identify, review, and contest denials and inappropriate payment. Document actions taken within the system.
• Possess a comprehensive understanding of Clinic contracts, carrier specific, State or Federal governmental, CMS, or CPT billing and reimbursement guidelines, to include NCCN and FDA guidelines. Review bulletins, updates, etc., maintain guidelines as reference/resource material to assist in follow-up.
• Responsible for auditing all chemotherapy/Nurse run payments to ensure they are correct, and appeal claims as necessary.
• Act as liaison to the Chemotherapy/Nurse Run Department to ensure any special projects and requests are completed efficiently and correctly.
• Access available third-party and governmental online services. Access appropriate web sites to obtain current carrier guidelines, verify eligibility and re-files claims.
• Possess a comprehensive understanding of how to enter insurance information into the billing system. Review and edit registration information according to Clinic policy. Remain current on new FSC's that are created and understand how they are used.

Supervisory Responsibility None

Work Environment & Physical Demands Must be able to remain in a stationary position. Constantly operates a computer and other office productivity machinery, such as a calculator, copier and computer printer. The person in this position frequently communicates with customers. Must be able to exchange accurate information in these situations.

Travel No travel is expected for this position other than monthly meetings at CCR.

Requirements

Required Education and Experience

• High School graduate or equivalent. 6 years in a medical business office or related field.
• Experience with the claim’s adjudication process for multiple governmental agencies and private insurance carriers. Basic medical terminology. Current CPT and ICD-10 coding experience.

Preferred Education And Experience

AA degree or minimum of 2 years’ experience with retail pharmaceutical disruption as well as an understanding of units of measure with drug distribution. A knowledge of drug uses based on clinical DX.

Additional Eligibility Qualifications

• An aptitude to retain detailed information. Ability to be multi-tasked oriented, to prioritize and to produce an acceptable volume of work.
• Excellent organizational and problem solving skills. Excellent communication skills, oral and written.
• Basic knowledge of Windows-based computer applications. Accurate typing rate of 40 wpm. Ability to operate the following equipment: computer, copier, fax, and 10-key calculator.

Seniority level:
Mid-Senior level.

Employment type:

Full-time. Job function:
Accounting/Auditing and Finance. Industries: E-Learning Providers.

Location:

Lakeland, FL. Salary range: $60,000.00-$65,000.00.