University of Virginia
Referral/Billing/Reimbursement Coordinator - Oncology
University of Virginia, Charlottesville, Virginia, United States, 22904
Provide billing and compliance support within the Division of Radiation Oncology to include; compliance and charge capture, referral/medical necessity, denial management/data collection and follow up, and project management. This position provides business support to clinic and administrative personnel within the Division of Radiation 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.
Position Compensation Range: $18.37 - $36.74 Hourly
Benefits
Comprehensive Benefits Package: Medical, Dental, and Vision Insurance
Paid Time Off, Long-term and Short-term Disability, Retirement Savings
Health Saving Plans, and Flexible Spending Accounts
Certification and education support
Generous Paid Time Off
UVA Health (https://jobs.virginia.edu/why-uva-health) is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report "Best Hospitals" guide (https://health.usnews.com/best-hospitals/area/va/university-of-virginia-medical-center-6344000) rates UVA Health University Medical Center as "High Performing" in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children's (https://jobs.virginia.edu/uva-childrens) is named by 2023-2024 U.S. News & World Report (https://health.usnews.com/best-hospitals/area/va/university-of-virginia-childrens-hospital-PA6344000) as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.
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.
Position Compensation Range: $18.37 - $36.74 Hourly
Benefits
Comprehensive Benefits Package: Medical, Dental, and Vision Insurance
Paid Time Off, Long-term and Short-term Disability, Retirement Savings
Health Saving Plans, and Flexible Spending Accounts
Certification and education support
Generous Paid Time Off
UVA Health (https://jobs.virginia.edu/why-uva-health) is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report "Best Hospitals" guide (https://health.usnews.com/best-hospitals/area/va/university-of-virginia-medical-center-6344000) rates UVA Health University Medical Center as "High Performing" in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children's (https://jobs.virginia.edu/uva-childrens) is named by 2023-2024 U.S. News & World Report (https://health.usnews.com/best-hospitals/area/va/university-of-virginia-childrens-hospital-PA6344000) as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.