Under the general direction of the Assistant Administrative Director of Radiation Oncology, this technician is responsible for accurate coding and charging of all Radiation Oncology encounters including diagnosis and procedure charges, billing and collection of accounts, posting of payments, and providing customer service regarding the disposition of accounts. Coding classification systems include ICD-10-CM and CPT/HCPCS. This technician performs ongoing record reviews to assess completeness and timeliness of information.This person is responsible for validating and correcting charges for professional services, as well as planning, treatments, and procedures for the radiation oncology service line and responding to line item and claim level edits and denials. He/She works with physicians and professional staff to obtain any necessary clarification concerning diagnosis and procedures and is responsible for monitoring certain reports such as the daily charges and reconciliation lists. He/She must have a thorough understanding of service line specific reimbursement rules and edits, and application of Local and National Coverage Determinations (LCD/NCDs) and billing policies. This person performs all work independently, with a high degree of autonomy.All work is carried out in accordance with the department’s approved policies and procedures. This position is an advanced level technical position within Radiation Oncology.
1.Assigns, validates and corrects codes and charges for Radiation Oncology services according to the appropriate classification system, and in accordance with applicable policies, procedures and guidelines. following the interpretation of these provisions as issued by the American Hospital Association, American Society of Therapeutic Radiation Oncology (ASTRO), American Medical Accounting and Consulting (AMAC), and all governmental and private Third-Party rules and regulations.
2.Identifies and interprets claim edits and payment variances, ensuring accurate reimbursement from third party payers. Resolves/responds to claim denials for designated service line in a timely manner to mitigate revenue loss.
3.Calculates and posts charges for professional services, as well as planning, treatments, and procedures for the radiation oncology service line. Adds appropriate modifiers and reviews accounts for charge errors, correcting them or referring them to the appropriate resource to ensure accurate billing.
4.Consistently meets (100%) productivity target, and quality requirements (95% or higher).
5.Completes continuing education required to maintain competency and credentials if applicable, and to stay current with applicable guidelines and rules.
6.Functions independently in a high volume, multi-task setting and competently completes assigned work within a highly computerized/technical environment. Maintains or adjusts work schedule to enhance team/department performance.
7.Collaborates with physicians and other direct patient care professionals in questions regarding level of detail for diagnostic and charge entries, according to the organization’s guidelines.
8.Promotes public relations through prompt and courteous service.
9.Fosters respect for patient privacy by maintaining confidentiality in all phases of work.
10.Performs those duties necessary to ensure all accounts are processed accurately, timely, andefficiently.