Medical Billing Counselor

2 weeks ago

Murrieta, California, United States Integrated Oncology Network, LLC Full time
Collaborating with Healthcare Professionals to Deliver Exceptional Patient Support

Integrated Oncology Network, LLC is dedicated to empowering our healthcare providers to offer timely and appropriate care in a supportive environment. We believe that maintaining the autonomy of medical practice, where patients receive care close to home from our committed team, leads to superior health outcomes. By fostering a seamless connection between our healthcare professionals, patients, and their support systems, we provide a unique approach to the patient's healthcare journey.

Role Overview:

The Patient Financial Advisor is responsible for ensuring that all tasks related to insurance eligibility and verification are conducted effectively to facilitate a personalized financial consultation with each patient. This consultation will occur in the early stages of treatment and aims to secure full payment of patient balances or establish a manageable payment plan.

Key Responsibilities:
  • Oversee the monitoring and collection of outstanding financial balances from patients throughout their treatment process.
  • Engage with patients to clarify treatment costs, insurance coverage, and their financial obligations.
  • Coordinate insurance verification details among both onsite and remote staff to ensure accurate financial information is provided.
  • Deliver a standardized cost estimate to patients within the initial weeks of treatment, clearly distinguishing between commercial rates and Medicare/Medicaid allowances.
  • Utilize all gathered information to update company financial records, ensuring data accuracy in both Centricity and the EMR systems, which is essential for billing and collections.
  • Discuss all payment and financial options with patients, serving as the primary contact for Financial Assistance applications and understanding poverty level calculations based on Federal guidelines.
  • Assist patients with inquiries regarding billing, insurance, and outstanding balances on their monthly statements.
  • Regularly update and monitor balances, providing the front office staff with detailed collection amounts for each patient.
  • Review the Aging Balance report monthly, generating new reports quarterly, and reporting findings to site leadership as requested.
  • Verify Centricity demographic information, ensuring HIPAA consent and billing releases are correctly documented, along with accurate diagnosis entries.
  • Identify overdue account balances in line with patient treatment plans and engage with patients to discuss outstanding balances during appointments, including follow-up communications as necessary.
  • Exhibit the ability to manage crisis situations by making prompt and informed financial decisions, applying professional judgment and ethical practices.
  • Collaborate closely with the Patient Navigator and front office team to ensure a smooth collection process.
  • Maintain regular attendance and punctuality.
  • Contribute to team objectives by achieving related results as required.
  • Ensure that all processing and reporting deadlines are consistently met.
  • Perform additional duties as assigned by management.
Qualifications and Educational Background:
  • Flexibility to work varied schedules as needed.
  • Minimum of two years of experience in a medical office environment dealing with insurance, coding, and financial matters.
  • Familiarity with medical terminology, including ICD-9 and CPT codes.
  • Strong communication skills, both written and verbal, along with financial assessment and crisis response capabilities, applied within established guidelines.
  • Associate's Degree or an equivalent combination of education and experience.
Preferred Skills:
  • Experience in financial counseling or budget/credit analysis and counseling.
Essential Competencies:

Demonstrated excellent judgment, reliability, and conscientious performance. Detail-oriented with exceptional interpersonal and communication skills. Compassionate and empathetic with high ethical standards. Proficient in operating complex equipment with manual dexterity.

Physical Requirements and Work Environment:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this role. Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.

Physical demands include walking, sitting, using hands to handle or feel objects, reaching, talking, and hearing. The employee must be able to lift and/or move up to 50 pounds. Specific vision abilities required for this role include close vision, distance vision, color vision, peripheral vision, depth perception, and clarity of speech, along with the ability to climb, balance, stoop, kneel, and bend.

Work environment involves exposure to environmental risks such as radiation and biohazards.

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