Cancer care is all we do
Hope in healing
Cancer Treatment Centers of America® (CTCA), part of City of Hope, takes a unique and integrative approach to cancer care. Our patient-centered care model is founded on a commitment to personalized medicine, tailoring a combination of treatments to the needs of each individual patient. At the same time, we support patients’ quality of life by offering therapies designed to help them manage the side effects of treatment, addressing their physical, spiritual and emotional needs, so they are better able to stay on their treatment regimens and get back to life. At the core of our whole-person approach is what we call the Mother Standard® of care, so named because it requires that we treat our patients, and one another, like we would want our loved ones to be treated. This innovative approach has earned our hospitals a Best Place to Work distinction and numerous accreditations. Each of us has a stake in the successful outcomes of every patient we treat.
The Billing Rep is responsible for timely and accurate claim creation and submission to all payers electronically utilizing the Patient Account system and Third Party Claim solution or through paper transmission in order to optimize reimbursement of CTCA hospital and physician accounts. Billing Reps are specialized in either hospital or physician billing and may be proficient in both. Billing Reps are responsible for the complete account cycle for all Medicare and Medicaid claims from insurance claim submission to account resolution. The Billing Rep completes claim edits for each payer and resubmits claims as necessary. The Billing Rep is responsible for billing the necessary claims with the appropriate CCI guidelines. The Billing Reps review, correct, and rebill all claim rejections via the 277 rejections received from the clearinghouse. The Billing Reps report directly to the Billing Supervisor.
60% Is specialized in specific billing which includes knowledge of UB and/or 1500 form locaters in paper and electronic format and insurance requirements as well as Medicare and Medicaid rules and regulations to ensure accurate billing is achieved.
Can perform all aspects of the billing teams function, including application of applicable financial policies for all insurances for each entity.
Capable of balancing, cash adjustments and charge entry functions, complete patient histories, financial hardship policy and payment plans in order to reconcile patient accounts.
Understands contract terms of reimbursement for managed care, government and third party payers, insuring that correct contractual and payments are posted and any additional terms of the contract are met prior to secondary carrier billing
30% Responsible for daily billing edits, return mail and late charges.
Analyzes Coding to check that guidelines are being met.
Completes rebill requests and billing secondary insurance.
Possesses a solid knowledge of ICD-10 codes, CCI guidelines, CPT/HCPCS codes, EOB’s, State and Federal insurance coding regulations and mandates.
Responsible for producing accurate billing forms in electronic and paper format.
Proficient in Accounts Receivable, Billing and 3rd party applications.
Completes printing of appropriate reports and accurate logging functions.
10% Alerts manager and supervisor of questionable situations, patterns or any situations resulting in delayed billing or potential financial loss to the corporation.
Communicate insurance and coding updates to manager, supervisor and coworkers as appropriate.
Education/ Experience Level
Must be a High School graduate or equivalent with strong analytical skills. Associate Degree Preferred.
Must have minimum of 1-3 years’ experience in registration, collection and verification in a healthcare setting or similar service profession.
Knowledge and Skills
Must have good written and verbal communication skills.
Must have basic knowledge of medical terminology.
Knowledge of PC and other office equipment with Windows experience a plus.
Must have experience with ICD-9/ICD-10 coding, insurance terminology and ability to read an Explanation of Benefits.
Must have basic knowledge of Medicare CCI edits.
Must have outstanding telephone communication and customer service skills.
Must be efficient, reliable, goal orientated and adaptable to change while maintaining productivity levels.
Must be able to perform routine mathematical, color coding and alphabetizing functions.
Must have excellent organizational skills, and be able to manage multiple priorities.
Must be Team oriented.
Must be courteous and professional.
Capable of operating all required computer applications and new applications as they are implemented
Maintains accurate patient demographics, patient confidentiality, insurance information
Routinely updates account comments of each account worked.
Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us. Visit: Jobs.cancercenter.com to begin your journey.
We win together
Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us.
Visit: Jobs.cancercenter.com to begin your journey.