Job Description

Department: Oncology

Reports To: Billing Manager

General Summary of Duties: This position is responsible for financially clearing, educating, and counseling patients in the infusion center prior to receiving treatment.

Essential Functions:

Review treatment regimens or orders to determine services to be rendered. Gather relevant data for eligibility and benefit verification including all diagnosis codes and billable CPT codes per orders. Verify eligibility and medical benefits with third party payers for scheduled services including but not limited to infusion treatment, injections, chemotherapy, and flow cytometry testing. Obtain prior authorizations, pre-determinations, or any prerequisites prior to services being rendered. Complete daily authorization report in the EMR. Ensure the patient meets all criteria as outline by the third party payer’s reimbursement policies and or clinical policies. Document detailed eligibility and benefit details in the patient’s electronic chart. Price regimens and treatment orders to calculate patient’s responsibility. Generate a patient financial treatment estimate and counsel each patient prior to the start of each new regimen or treatment. Identify patients in need of financial assistance and submit to the financial assistance department for evaluation. Document all patient financial counseling activities and interactions in the patient’s electronic chart. Generate a daily patient collection report for scheduled infusion center patients for the front desk staff. Reconcile the daily patient collection report against collections and prepare the daily deposit. Communicate to the infusion nurses and treating physicians any delays in the financial counseling process including patients that are not cleared for treatment in a timely manner. Communicate to the front desk staff any patients that need to be seen by financial counseling prior to services being rendered. Counsel, educate, and assist patients with inquiries regarding to their financial responsibility, assistance availability, insurance, and benefits. Perform other duties assigned by management.

Requirements:

High School Diploma or equivalent. Minimum of 2 years’ experience in Insurance Verification and/or obtaining authorization in a medical setting. Ability to project a professional image.

Knowledge/Skills:

Working knowledge of medical terminology including but not limited to; cpt codes and ICD10s. Proficiency with electronic medical records (EMR) and practice management software (PM). Strong knowledge of payer guidelines and reimbursement policies. Effective interpersonal and communication skills. Effective and stellar customer service. Ability to work independently and collaboratively within a team environment. Ability to organize, multi-task, and meet deadlines. Strong time management.

Company Description

Millennium Physicians Association is a multi-disciplinary medical group that offers a singular source for patient healthcare needs. Our practice is a diverse group of 42 physicians at ten different locations in the Greater Houston area The Woodlands, Kingwood, Tomball, Northwest Houston, Shenandoah, Cypress, Huntsville, Cleveland, Vintage Park, and now Atascocita. Millennium Physicians treats with the highest level of care, to get patients back living life to the fullest. Our doctors have a variety of specialties to offer including Medical Oncology, Radiation Oncology, Hematology, Pulmonology, Internal Medicine, Family Practice, Urology and General Surgery. Millennium Physicians largest medical branch is Medical Oncology. We are here to meet your needs at this difficult time and are aware that you and your family may be faced with making important decisions regarding cancer treatment choices. Millennium Physicians will be there every step of the way.