Billing Specialist II

4 weeks ago

Lexington Kentucky, United States CommonSpirit Health Full time
Overview:
Saint Joseph Hospital is a 433-bed facility located in Lexington Kentucky. Founded in 1877 a small group of Sisters of Charity of Nazareth in Kentucky led by Sister Euphrasia Stafford began their health ministry. Their mission was to provide compassionate care to the poor and underserved – a tradition still carried out today. Saint Joseph Hospital primarily serves central and eastern Kentucky with a full range of services including distinguished awards for cardiology orthopedics and stroke care. CHI Saint Joseph Health supports 5000 active employees 8 hospitals specialty clinics and a Medical Group with more than 200 locations across Central and Eastern KY. CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health in 2019. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsibilities:

Must have the CPC Certification

Job Summary / Purpose

Reporting to the Market Manager of the Oncology Support Services, the Billing Specialist II (Financial Navigator) will be responsible for providing financial services for adult oncology patients and families.  The position will be the patient’s point of contact for medical insurance, serving the patient with financial counseling, and all other billing questions.  The position will also report back to the multidisciplinary team.

Essential Key Job Responsibilities

 Verifies insurance, checks benefits, obtains patient responsibility from payer, etc.  

 Meets with the patient and his/her family during the interdisciplinary introduction meetings to review the patient’s insurance(s), insurance coverage, out-of-pocket costs, etc.  

Serves as patient liaison for financial matters throughout treatment, including following up on insurance and financial risk assessment every quarter.

 Assists patients with maximizing insurance benefits within the Medicare system, ACA Marketplace and Medicaid programs.

 Working with the patient, completes, files, and follows to resolution applications for Medicaid, Medicare Advantage, Medicare Supplemental policies, Medicare part D, Low Income Subsidy, Medicare Savings Program, ACA marketplace policies and other such programs. 

Assists patients in enrolling into external assistance programs such as pharmaceutical patient assistance programs, co-pay assistance programs, premium assistance programs, and other community-based programs that assist patients with their basic needs.

Refers patients to programs where Hospital staff cannot file directly for the patient, including Veteran's Services.

Works closely with and communicates consistently with Social Work, Case Management, Billing, and Contracting to provide a cohesive support system to the patient and the clinical providers.

Stays abreast of regulations, making certain that applications are appropriate and complete to ensure that the Hospital, the professional groups, and the patient receive all benefits for which the patient is eligible. 

Documents all meeting minutes and steps taken on an account.  Tracks every account.

Although these are the essential job responsibilities, modifications and additional responsibilities may occur at the Manager's discretion.

Qualifications:
Required Education for Staff Job Levels

High school diploma or equivalent required, Associate or Bachelor preferred.

Required Licensure and Certifications

Must be CPC Certified

Required Minimum Knowledge, Skills and Abilities

2 years billing or financial counseling experience in a healthcare environment required.

PREFERRED Qualifications

Experience with Oncology medical coding and billing; AHIMA certification

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