Medical Billing & Coding Specialist (Medical Oncology)

Location: United States; remote

Company

hirify.global supports community oncologists through a patient-centric, physician-driven, and technology-powered care model.

What you will do

• Write and maintain coding and billing rules in the practice management system.
• Review insurance coverage, eligibility, charges, and radiation oncology records for proton therapy, radiation therapy, and radiology services.
• Generate, submit, and track electronic and paper claims through the billing process.
• Investigate and resolve claim rejections, denials, appeals, payer roadblocks, and pending insurance or referral issues.
• Run and maintain ACE edits and rules, including daily reviews of charges in “Approve Failed” and “Hold” status.
• Collaborate with medical, pre-authorization, clinical, and practice leadership teams on accurate billing, documentation, and coding compliance.

Requirements

• At least two years of charge entry or medical billing experience.
• At least one year of prior authorization experience.
• Extensive knowledge of CPT, HCPCS, and ICD-9 coding and medical insurance billing guidelines.
• Experience with medical insurance policies and regulations, including Medicare and Medicaid.
• Proficiency with Microsoft Excel, Outlook, databases, patient scheduling systems, and other medical information systems.
• Strong verbal and written communication, customer service, organization, attention to detail, and problem-solving skills.

Nice to have

• Bachelor’s degree.
• Working knowledge of hospice and other payer requirements.
• Knowledge of clinic office procedures, medical practice, and medical terminology.

Culture & Benefits

• Values-driven environment with startup enthusiasm and support from leaders in oncology, urology, technology, and finance.
• Direct supervision from the relevant team manager.
• Remote work arrangement in the United States.
• Collaboration with medical, authorization, clinical, and practice leadership teams.