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BMT Biller

Company: City Of Hope
Location: Azusa
Posted on: November 15, 2021

Job Description:

About City of Hope City of Hope, an innovative biomedical research, treatment and educational institution with over 6000 employees, is dedicated to the prevention and cure of cancer and other life-threatening diseases and guided by a compassionate, patient-centered philosophy. Founded in 1913 and headquartered in Duarte, California, City of Hope is a remarkable non-profit institution, where compassion and advanced care go hand-in-hand with excellence in clinical and scientific research. City of Hope is a National Cancer Institute designated Comprehensive Cancer Center and a founding member of the National Comprehensive Cancer Network, an alliance of the nation's leading cancer centers that develops and institutes standards of care for cancer treatment. Position Summary: Receives and reviews data for global and non-global BMT case rate accounts. Contact patients, guarantors, Managed Care Department, BMT Coordinators, Case Managers and/or third-party organizations to secure all documentation needed for billing. Verifies accuracy of patient demographic and information. Calculates expected reimbursement for global and non-global case rates period and prepares calculated contract rate sheets to submit with the claims. Key Responsibilities include: + Reviews Admit and Discharge report daily to capture the BMT patients. + Creates Inpatient and Outpatient folders for services BMH, BMO, BMV, BMR, and BMT and identifies which are special contracts with special billing instructions. + Monitors the Inpatient and Outpatient accounts and gathers all pertinent information for billing. + Reviews weekly Autologous and Hematology schedules to capture the start of the case rate period. + Request Physician bills, Home Health, Pharmacy and Village claims for global case rate contracts upon patient discharge from COH. + Transfers donor charges to the BMT accounts. + Works with very complex contracts carve outs and exclusions that involve several accounts for the global period Inpatient and Outpatient claims. + Calculates the expected reimbursement for global and non-global case rates and submits contractual write-offs timely. + Verifies BMT dates of service, harvesting, stem cell collections and ablative dates for high dose chemo or high dose radiation, and reviews Oasis system for notes and/or treatment plan to ensure proper reimbursement for a specific contract. + Collection of National Marrow Donor Program (NMDP) invoices for contracts that specify this as additional reimbursement in addition to the case rate amount. + Collect on Kaiser Non-BMT accounts for Inpatient and Outpatient. + Update the Non-BMT Kaiser report on a weekly basis. + Monitors post transplant accounts, which could extend up to a year for proper reimbursement. + Comprehends complex BMT contracts and language interpretations. + Demonstrates ability to work independently with minimal direct supervision. + Provides coverage for the BMT collector when absent. Basic education, experience and skills required for consideration: + High School or equivalent. + Experience may substitute for minimum education requirements. + Three year in the medical insurance field. Experience with Managed Care. Working knowledge of routine office procedures. Required Courses/Training: + Strong knowledge of third party/government program billing requirements, patient billing procedures. Additional Information: + To protect the health of patients and staff and to comply with new State of California mandates, City of Hope staff are required to show proof of full vaccination by September 30, 2021. Compliance is a condition of employment. + This position is represented by a collective bargaining agreement. City of Hope is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, or status as a qualified individual with disability. #LI-CG + Posting Date: Oct 15, 2021 + Job Field: Business Services + Employee Status: Regular + Shift: Day Jobby Jobble

Keywords: City Of Hope, Azusa , BMT Biller, Other , Azusa, California

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