Under minimal supervision, is responsible for insurance verification and eligibility, assessment of patient financial requirements, counseling patients on insurance benefits and co-payments. Obtains pre-authorization of services. Obtains and maintains accurate patient demographics. 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 and entered into the system in an accurate manner.
-Performs insurance verification process on all third party payers. Obtains initial and subsequent pre-authorization for services and surgeries.
-Re-verifies benefits and obtains authorization and/or referral after treatment plan has been discussed, prior to initiation of treatment. Ensures appropriate signatures are obtained on all necessary forms.
-Utilizes the Summary of Patient Reimbursement and Liability form and obtains appropriate approvals as required.
-Performs financial counseling process on all patients prior to treatment, which includes patient financial obligations, billing practices and establishing payment arrangements.
-Documents financial counseling process and forwards to Billing Office.
-Assists patients in obtaining financial assistance (i.e. Medicaid, drug replacement), outside assistance (i.e. transportation or other community services), and all appropriate forms filled out.
-Collects co-pays, deductible and other out of pocket amounts at time of visit.
-Assists in maintaining manuals, logs and other required documentation as required.
-Demonstrates an understanding for patient confidentiality to protect the patient and the clinic/corporation.
-Follows policies and procedures to contribute to the efficiency of the front office. Covers for and assists with other front office functions as requested.
High school diploma or equivalent required. Minimum three years of medical business office experience with insurance procedures and patient interaction.
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. Work may require sitting for long periods of time; also stooping, bending and stretching for files and supplies. Occasionally lifting files or paper weighing up to 30 pounds. Requires manual dexterity sufficient to operate a keyboard, calculator, telephone, copier and other office equipment. Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts. It is necessary to view and type on computer screens for prolonged periods of time.
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 is performed in an office environment. Involves frequent interaction with staff, patients and the public.
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.