Billing and Charge Specialist-Oncology job – Botsford Hospital – Michigan

Under the direction of the Cancer Center Director the Oncology Billing and Charge Specialist is responsible for Radiation Oncology charge review and export, in addition to writing appeal and medical necessity letters. Responsible for assessment of daily charge entry functions and cross-referencing patient charges with medical records to determine that all items charged are supported by medical record documentation making corrections on individual charges reviewed, identifies patterns of items either not consistently charged or not appropriately charged, and formulates corrective action plans. The Oncology Billing and Charge Specialist also identifies new chargeable transactions for inclusion in the hospital’s Charge Description Master (CDM), participates in the education of hospital staff responsible for the charge capture process and assists the System Business Office (SBO) in conducting insurance audits and appeals.

BASIC QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

A. Education / Training: Requires successful completion of a registered radiation therapy program from an accredited school and hold a valid ARRT license.

B. Work Experience : Requires a minimum of five years’ experience with Radiation Oncology practices as it relates to review, interpretation, analysis and understanding patient billing for services and cross referencing with patient medical records

C. Contacts and Communications: Requires excellent communication and interpersonal skills to interact frequently with professionalism and tact with physicians, licensed/non licensed staff, hospital and business office financial staff, external insurance vendors, third party payors, and regulatory agencies. Requires the ability to effectively discuss complex and technical issues with a diverse audience.

D. Analytical Demands : Requires s ignificant analytical skills to analyze, interpret and understand and resolve billing and documentation requirements, work processes, regulatory compliance, and third party payment issues.

E. Computer Skills : Requires demonstrated f amiliarity with spreadsheet software, the ability to recognize data patterns, and perform computational skills.

F. Certification, Licensure, Registration : Requires a current and unrestricted Radiation Therapy ARRT license in the State of Michigan.

G. Other Qualifications : Must be able to keep abreast of current regulatory developments with respect to charge capture compliance and coding issues affecting Radiation Oncology.

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