Under general supervision, is responsible for payer and patient account balances being paid timely and remaining current. Performs collection activities such as monitoring delinquent accounts, contacting patients for account payment, resolving billing problems, and answering routine and non-routine account inquiries. Follows standard procedures and pre-established guidelines to complete tasks. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards, and US Oncology*s Shared Values.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
-Monitors delinquent accounts and performs collection duties. Reviews reports, identifies denied claims, researches and resolves issues, may perform a detailed reconciliation of accounts, resubmits claim to payer. Reviews payment postings for accuracy and to ensure account balances are current. Works with co-workers to resolve payment and billing errors. Monitors and updates delinquent accounts status. Recommends accounts for collection or write-off. -Verifies existing patients have necessary referral and/or authorization documentation prior to examination date. Contacts and follows-up with patient*s physician for any missing or incomplete documentation. -Contacts patients to secure past due balances, verify patient demographics and insurance providers, updates information in systems, and documents conversations. Answers patient*s payment, billing, and insurance questions and resolves complaints. May refers patients to Patient Benefits Representative to set-up payment plans. -Contacts third party payers to resolve payer issues, expedite claim processing, and maximize medical claim reimbursement. - Maintains credit balances of patients and payors ensuring timely refunds within government guidelines/regulations.
-Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient*s records. -Other duties as requested or assigned.
COMPETENCIES: - Experience with Gynecology oncology and/or surgery preferred. -Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; accesses and uses other expert resources when appropriate. -Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility. -Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty. -Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them. -Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.
The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.
The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.
The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.
Internal Number: MCKEA00878126
About US Oncology Network
The US Oncology Network believes local cancer care is better care. We empower the delivery of advanced integrated cancer care through our network of independent physicians who share expertise and resources to provide quality, value-based care close to home.
Our clinical and business support capabilities, expertise and industry-leading technologies keep local practices at the forefront of high quality, efficient care delivery while enabling practice success, quality of life and financial security for physicians.
- 25 years of oncology practice management expertise
- Leader in value-based cancer care with over 900 physicians participating in the Center for Medicaid and Medicare
- Innovation Oncology Care Model – one fourth of the entire population of physicians nationwide
- Over 1,400 affiliated physicians
- More than 450 cancer treatment center locations across the United States
- Over 995,000 patients treated annually