Referral/Billing/Reimbursement Coordinator - Oncology

• Assures that all referrals are managed effectively and efficiently for Radiation Therapy Services.
• Provides high-level customer service to both referring physicians as well as referred patients. Verifies medical necessity for all radiation treatments based on patient's diagnosis and medical insurance.
• This job requires the application and interpretation of policies and procedures and the use of independent judgment in a medical setting.
• The individual must possess the ability to maintain a working knowledge of carrier contracts/changes and departmental policies and procedures.
• Review insurance guidelines to determine if criteria are present for proceeding with planned treatment.
• Maintain thorough knowledge of insurance company criteria and radiation specific billing codes.
• Communicate with physicians, department billing team, and preauthorization team to ensure accurate precertification/authorization information is aligned with accurate billing of services.
• Performs all other related tasks which would facilitate the flow of patients through the process, or which would enhance the quality of service to patients.
• Review patient documentation to abstract clinical data information and assess appropriate level and assign the appropriate codes for radiation treatment and procedures prior to exporting to claim. Evaluation and Management - Consults.
• In addition to the above job responsibilities, other duties may be assigned.

MINIMUM REQUIREMENTS
Education: High School Diploma
Experience: 2 years relevant experience
Licensure: Relevant coding certification, such as Radiation Oncology Certified Coder (ROCC), from an accredited organization, Strongly Preferred.

PHYSICAL DEMANDS
This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally require traveling some distance to attend meetings, and programs.

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