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Skills
Accounts Receivableunmatched
Accounts Receivable Managementunmatched
Billingunmatched
Biotech and Pharmaceuticalunmatched
Cancerunmatched
Chemotherapyunmatched
Claims Processingunmatched
Co-Paymentsunmatched
Communication Skillsunmatched
Compensation and Benefitsunmatched
Computer Skillsunmatched
Cost Estimatesunmatched
Credit Cardsunmatched
Current Procedural Terminology (CPT)unmatched
Customer Support/Serviceunmatched
Customer/Consumer Behaviorunmatched
Electronic Medical Recordsunmatched
Epic Systemsunmatched
FDA (Food and Drug Administration)unmatched
File Maintenanceunmatched
Financial Analysisunmatched
Financial Servicesunmatched
GE Centricityunmatched
Governmentunmatched
Health Planunmatched
Healthcare Common Procedure Coding System (HCPCS)unmatched
ICD-10unmatched
Insuranceunmatched
Interpersonal Skillsunmatched
MEDITECHunmatched
Medical Assistanceunmatched
Medical Officeunmatched
Medical Recordsunmatched
Medicareunmatched
Microsoft Officeunmatched
Microsoft Product Familyunmatched
Multilingualunmatched
Nonprofitunmatched
Nursingunmatched
Organizational Skillsunmatched
Past Due Accountsunmatched
Patient Confidentialityunmatched
Patient Educationunmatched
Patient Registrationunmatched
Pharmacyunmatched
Presentation/Verbal Skillsunmatched
Professional Servicesunmatched
Systems Maintenanceunmatched
Time Managementunmatched
Writing Skillsunmatched
Description
MAJOR ACCOUNTABILITIES/CRITICAL RESPONSIBILITIES:
Demonstrates understanding of the revenue cycle.
Performs follow up of claims. Maintains files and contacts appropriate parties to determine correct status and follow up of unpaid accounts. Processes and follows up on all assigned patient accounts until paid in full, managing accounts receivable for professional service billing.
Updates receivable system with any new, corrected or pertinent information in relation to resolution of receivable accounts, and insures that proper information for follow up is shown in GE Centricity, Meditech and/or Epic, as appropriate..
Understands and accurately applies requirements for pre-certification of chemotherapy drug regimens; pre-certifies treatments as indicated by government and private insurers.
Insures eligibility and benefits are properly verified prior to initial visit and thereafter as directed.
Makes daily manual deposits as needed. Balances credit card machines with other deposits as required.
Pre-registers patients. Demonstrates ability to have meaningful discussion of benefits with patient when pre-registering in Meditech or Epic, and when present in the department.
Performs patient financial counseling. Evaluates care plans and communicates with patient, sends cost estimates to patients to establish payment expectations based on individual insurance benefit plans.
Is able to learn quickly and demonstrate proficiency with various software programs, including Meditech and GE Centricity, Epic and other applications as required.
Assists physicians in determining approved regimens for treatment. Familiar with NCCN, FDA and Medicare guidelines and insures that regimens are approved according to same.
Demonstrates knowledge of coding for ICD-10, CPT and HCPCS.
Applies department processes for non-profit, community, pharmaceutical, federal, state and health system financial assistance programs. Demonstrates knowledge of Federal and State requirements for the No Surprises Act and assistance for patients with inability to pay.
Demonstrates knowledge of drug replacement programs, grant programs, co-pay foundation programs and other cancer-related patient support options. Processes and monitors applications and captures highest level of value to patient and institution.
Provides timely and accurate information regarding patient data/status to other health system departments, physicians, physician office staff, nursing, pharmacy, and public agencies while insuring patient confidentiality is not breached.
Has some familiarity with electronic billing, edits, and claim submission and processing electronic remittance advice, posting payments, and claim appeals.
Performs other related duties as assigned or requested in order to maintain a high level of service.
ADDITIONAL QUALIFICATIONS/REQUIREMENTS:
High School diploma or equivalent required, some college or business school training preferred.
Five (5) or more years prior equivalent experience in a business setting is preferred.
Is self-disciplined & organized, and able to complete work and monitor accounts independently with minimal daily supervision.
Completes required continuous training and education, including department specific requirements.
Demonstrates professional work behavior and excellent customer services skills at all times by following Stamford Health's code of Conduct and Service Standards.
Demonstrates strong interpersonal and verbal/ written communication skills.
Complies with departmental organizational policies and procedures and adheres to external agency requirements.
Bilingual preferred but not required.
A high degree of computer literacy in a PC environment is required, including Microsoft office products. Previous EMR / PM system experience required.