Medical Billing Specialist

Make a difference! A diagnosis unlike any other, deserves a pharmacy unlike any other. We are hiring a Pharmacy/Medical Billing Specialist at our Houston, TX location.

The pay starts at $23 an hour. The hours are 8:30-5 CST Monday through Friday.

Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.

A career with us is more than just a job. It's an opportunity to connect and care for our patients, providers, communities and each other. We attract extraordinary people who have a strong desire to live our mission - to better the lives of those battling cancer and rare diseases. Compassion is more important than numbers. We value teamwork, respect, integrity, and passion.

We succeed when you do, and our company and management team work hard to foster an environment that provides you with opportunities for both professional and personal growth.

We offer a variety of benefits including:

• Medical; Dental; Vision
• 401k with a match
• Paid Time Off and Paid Holidays
• Tuition Reimbursement; Quarterly Incentive Bonus; Referral Bonus
• Company paid benefits – life insurance; and short and long-term disability
  
  

The Medical Billing role will be responsible for medical billing of company specific IV and oral therapies on CPT platform. Daily functions require working knowledge of HCPC coding, ICD-10, JCodes, and CPT codes as well as experience interacting with Medicare, Medicaid, and Commercial insurances. Individual must be able to perform the essential functions of this position as listed below.

Pharmacy / Medical Billing Specialist Major Responsibilities:

• Research proper billing policies and procedures for all payer types, ensuring claims are processed correctly against industry and government standards and regulations, adhere to company compliance, integrity, patient privacy and ethical billing practices.
• Manage and process claims for all Ready to Bill (pending revenue); perform Quality Assurance to ensure accurate and timely creation of claims and paper invoicing. Process confirmed tickets in “unworked” status within 48 hours of confirmation date; work “unresolved” unbilled tickets within 24 hours to “ready” or next status for resolution.
• Assign appropriate status to ensure appropriate handling by branch and billing personnel; make necessary demographic changes to reduce rejections of submitted electronic and paper claims.
• Review delivery tickets for accuracy and complete claims per payer specific guidelines. Identify patterns of non-compliance in completing patient registration, supporting documentation and delivery tickets and escalate to leadership.
• Efficiently uses company billing software platform, including maintaining accurate and detailed patient and billing notes to assist in documentation and collection of claims.
• Must be able to communicate succinctly and professionally both verbally and through written correspondence with Physician offices, nurses, insurance companies and patients as needed.
• Exhibits a positive, courteous, respectful and helpful attitude towards patients, team members, payers, and management.
• Work within specified deadlines and open to overtime when necessary to meet department goals and objectives.
• Performs other tasks as assigned.
• Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
  
  

Pharmacy / Medical Billing Specialist Qualifications

• Education/Learning Experience
• Required: 3 years experience Medical, HCPCS billing
• Desired: Specialty Pharmacy Infusion Billing

• Work Experience
• Required:1-3 years experience
• Desired: 3 years
• Skills/Knowledge
• Required: Medicare HCPCS
• Desired: Specialty Pharmacy
• Behavior Competencies
• Required: Deadline Oriented, Time Management, Prioritization Skills