Highlands Oncology began in 1996 with three physicians and a desire to change the face of oncology care in our community. Dr. Malcolm Hayward, Dr. Dan Bradford, and Dr. Thad Beck knew that patients do better at home, in the community where they live and work, and where their support system is already in place. In furthering that goal, Highlands has grown with the region from a single location 26 years ago, to 6 locations in Northwest and Northcentral Arkansas today employing more than 750 diverse team members.

As Northwest Arkansas continues to grow, so must the services and providers available in the region. Highlands Oncology is committed to remaining on the cutting edge to ensure our community has access to the very best cancer care. What we have is something quite unique right here in our own backyard with a caring multidisciplinary team focused on treating patients like family.

Job Summary:The Billing Representative plays a vital role in processes related to insurance denials, billing, charges, and prior authorizations associated with patient accounts and treatments within Radiation Oncology. The primary focus of this position will be investigating and resolving insurance denials, with cross-training and support responsibilities in charge entry and prior authorization workflows.

Job Duties / Responsibilities:

• Investigate and resolve insurance denials from all carriers, including working outstanding claims and submitting appropriate documentation and appeals.
• Review denial trends, identify recurring issues, and communicate findings to help prevent future denials.
• Obtain and provide medical records or other documentation requested by insurance carriers to substantiate payment of claims.
• File and follow up on appeals as necessary.
• Communicate directly with insurance representatives and internal and external customers regarding claim status, denials, and resolution.
• Maintain an updated working knowledge of insurance carrier requirements, billing guidelines, and authorization parameters.
• Cross-train in radiation charge entry, including preparing and entering verified and validated radiation charges.
• Assist with the collection and reconciliation of radiation charges.
• Cross-train in prior authorization processes and provide prior authorization support as needed.
• Collaborate with Physics, Physicians, Medical Records, and other departments to obtain requested information and complete the transfer or submission of documentation.
• Assist with tracking documentation needed from physicians for billing and claim resolution.
• Meet with and assist patients with statements and Cancer Policy questions.
• Assist with tracking hospital and rehabilitation facility inpatients for appropriate billing and send monthly statements.
• Help develop financial reports and treatment statistics for Administration and Physicians.
• Assist others in the billing department with reporting, coding and compliance, and MIPS.
• Maintain patient and clinic confidentiality in accordance with HIPAA and comply with all organizational policies and procedures.
• Attend financial and administrative meetings as designated by management or physicians.

Required Skills/Abilities:

• Proficient utilization of multiple EMR systems, organizational software programs (Centricity), and computer skills including Excel and Word are required.
• Must possess the ability to adapt to the changing billing requirements of CMS, Medicaid, and private insurance companies.
• Professional communication and etiquette via phone and computer.
• Professional attitude with excellent service to both internal and external customers.
• Ability to work independently and as part of the healthcare team.

Education and Experience:

• High school graduate or equivalent
• 1 year of medical experience; Oncology Medial Assistant preferred not required.
• 1 to 2 years minimum of medical terminology.
• Experience with practice management and electronic medical record software required.
• Knowledge and experience with medical billing required, and procedure coding preferred.

Physical Requirements:

• Sitting for extended periods of time at a desk workstation with extensive computer usage
• Manual dexterity for typing, handling documents, and office equipment use
• Visual acuity for reading and screen usage
• Light lifting and carrying of up to 25 pounds for standard office supplies
• Reaching, bending, walking, and standing
• Hearing and speaking for phone communication and verbal interactions

Work Environment:

• The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. Reasonable accommodation may be provided to enable individuals with disabilities to perform essential functions.
• Due to the nature of our business and the use of radiation and hazardous chemicals, it is imperative that all employees foster a culture and environment of safety.
• Safety Sensitive: In accordance with the Arkansas code this position is designated as a safety sensitive position wherein the employee performing the job duties under the influence may constitute a threat to health or safety.

Highlands Oncology offers a full suite of benefits that includes those pictured below and MANY MORE...

*Certified a Great Place to Work!