Physician Billing Rep

Philadelphia, PA - USA

Monthly Salary: Not Disclosed

Posted on: 23 hours ago

Vacancies: 1 Vacancy

Job Summary

Job Details

Physician Billing Representative

Job Description

PRIMARY RESPONSIBILITIES:

The Billing Coordinator for Oncology is responsible for securing timely and accurate insurance authorizations and reauthorizations for outpatient infusion services. This role ensures that all required clinical and administrative documentation is obtained verified and submitted to payers to facilitate patient access to treatment without delays. The specialist serves as a key liaison between the clinical team patients and insurance providers verifying that all payer requirements are met prior to scheduled infusions.

Additional responsibilities include tracking authorization statuses following up on outstanding requests resolving payer inquiries and supporting the clinical and billing teams to maintain accurate records. The role requires staying current on insurance policies payer requirements and regulatory guidelines to ensure compliance and smooth patient care coordination.

The Billing Coordinator works with the Billing Manager and Business Manager to ensure adherence to all regulatory and HIPAA guidelines.

ESSENTIAL FUNCTIONS:

Review and process infusion referrals by verifying patient insurance coverage and benefits and obtaining prior authorizations for infusion medications and services.
Collaborate with internal teams including providers case managers pharmacy and billing to ensure accurate clinical documentation and resolve any issues related to authorizations or claim denials.
Track and manage authorization workflows by monitoring pending requests appealing denials as needed and ensuring timely follow-up to avoid treatment delays.
Maintain accurate records of all authorization activities and communications in the electronic health record (EHR) or designated systems.
Ensure compliance with payer requirements HIPAA regulations and internal protocols while consistently demonstrating professionalism and the hospitals core values in all interactions.

EDUCATIONAL/TRAINING REQUIREMENTS:

High School Diploma

Must pass all required training for EPIC

CERTIFICATES LICENSES AND REGISTRATION:

N/A

EXPERIENCE REQUIREMENTS: Must be experienced with Excel or complete courses offered by Jefferson IT within two months

Work Shift

Weekend Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Abington Memorial Hospital

Primary Location Address

925 Chestnut Street Philadelphia Pennsylvania United States of America

Nationally ranked Jefferson which is principally located in the greater Philadelphia region Lehigh Valley and Northeastern Pennsylvania and southern New Jersey is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65000 people strong dedicated to providing the highest-quality compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrows professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic clinical and applied research. Thomas Jefferson University home of Sidney Kimmel Medical College Jefferson College of Nursing and the Kanbar College of Design Engineering and Commerce dates back to 1824 and today comprises 10 colleges and three schools offering 200 undergraduate and graduate programs to more than 8300 students. Jefferson Health nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age race color religion creed sexual orientation gender gender identity marital status pregnancy national origin ancestry citizenship military status veteran status handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues including medical (including prescription) supplemental insurance dental vision life and AD&D insurance short- and long-term disability flexible spending accounts retirement plans tuition assistance as well as voluntary benefits which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues including those who work less than part-time(including per diemcolleagues adjunct faculty and Jeff Temps) have access to medical (including prescription) insurance.

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Required Experience:

Job DetailsPhysician Billing RepresentativeJob DescriptionPRIMARY RESPONSIBILITIES:The Billing Coordinator for Oncology is responsible for securing timely and accurate insurance authorizations and reauthorizations for outpatient infusion services. This role ensures that all required clinical and adm...