Under minimal supervision, performs general business office functions that may include some or all of the following: billing and claim submissions; charge capture and payment posting; insurance verification and eligibility; obtaining pre-authorization; counseling patients and families on insurance and payment issues; and account follow-up and payment resolution. As necessary, assists patients and families with obtaining community resources including, but not limited to, housing, transportation, and financial support. May orient, train, and assign the work of lower level employees. May be designated as the lead employee. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.
ESSENTIAL DUTIES AND RESPONSIBILITIES :
-Ensures all insurance, demographic, and eligibility information is obtained from patients and entered into the system in an accurate and timely manner. Registers patients in the system as necessary. -Collects and reviews all patient insurance information and completes insurance forms. Collects co-pays, deductibles and other out of pocket amounts at the time of visit. -Confirms patient insurance verification and eligibility. Obtains pre-authorization of services and/or referrals. Assesses patient financial requirements and advises patients and families on insurance benefits, co-pays and financial obligations. -Posts line items and adjustments to patient accounts. Balances receipts, reconciles daily work batches and prepares audit trail. Prepares deposits for bank as needed. -Reviews Explanation of Benefits (EOB) for consistency. -Submits files and processes all claims for payment. Researches and resolves claim delay issues. -Resolves patient questions and complaints regarding insurance billing and adjusts accounts as necessary. Resubmits claims and processes all insurance/patient correspondence. Provides all documentation to expedite payment. -Follows-up on assigned accounts. Uses collection techniques to keep accounts current including monitoring for delinquent payments. -Sets-up financial arrangements with patients as necessary. -As necessary, assists patients with researching and obtaining community resources including housing, transportation, drugs and pharmaceutical supplies, and financial resources. -May provide guidance and daily work direction to junior level staff.
MINIMUM QUALIFICATIONS :
High School Diploma or equivalent required. Minimum five years medical business office experience.
PHYSICAL DEMANDS :
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 regularly required to sit and use hands to finger, handle, or feel. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 30 pounds. Requires vision and hearing corrected to normal ranges. Requires vision and hearing corrected to normal ranges.
WORK ENVIRONMENT :
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work requires frequent interaction with patients and staff.
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: MCKEA00877929
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