With minimal 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 to complex account inquiries. Performs responsibilities within standard procedures and pre-established guidelines to complete tasks. A certain degree of creativity and latitude is required. 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 refer 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.

-Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient’s records.

-Maintains credit balances of patients and payors ensuring timely refunds within government guidelines/regulations.

-Proactively identifies processes and procedures and develops tools to improve efficiencies.

-Other duties as requested or assigned.

MINIMUM QUALIFICATIONS:

High school graduate or equivalent required. Associates degree in Finance, Business or four years revenue cycle experience preferred. Minimum two (2) years insurance resolution experience resolving issues with patients and payers as well as four (4) years combined medical billing and payment experience required.

-Proficiency with computer systems and MicroSoft Office (Word and Excel) required.

-Demonstrate knowledge of oncology medical coding.

-Demonstrate knowledge of state, federal, and third party claims processing required.

-Demonstrate knowledge of state & federal collections guidelines

POSITION POSTED UNTIL FILLED.