An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.
The US Oncology Network is looking for an Analyst I - Reimbursement to join our team at Texas Oncology. This full-time remote position will support the Charge Corrections/Edits Department at our 3001 E. President George Bush Hwy Suite 100 location in Richardson, Texas. Typical work week is Monday through Friday 7:00a - 5:00p (flexible hours). Note from
Hiring Manager:
We're proud of our strong employee retention and high job satisfaction. Our supportive culture and comprehensive training program set coders up for long term success, growth, and fulfillment in their careers. This position will be a level 1 based on relevant candidate experience. As a part of The US Oncology Network , Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas, our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today—at Texas Oncology , we use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve "More breakthroughs. More victories." ® in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis. The US Oncology Network is one of the nation's largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care. What Does the Analyst I - Reimbursement do ? Working under limited supervision, prepares and submits patient claims to appropriate third party payers. Reviews claims to ensure that payer specific billing requirements are met. Follows standard procedures and pre-established guidelines to complete tasks. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards, and US Oncology's Shared Values. This position reports to the Director of Charge Entry and Revenye Cycle Support Services. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.
Responsibilities:
The essential duties and responsibilities: Ensures claim forms are completely and accurately filled out. Updates and maintains patient billing data and ensures documents are current. Reviews patient charts for completeness. Enters charges, processes, and submits insurance claims to third party payer. Completes data entry of the charges into Practice Management System. Completes review of interface transactions and resolution of TES edits. Identifies and reports any payer trends, denial patterns, and delays to management. Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient's records and collections. Maintains strict confidentiality of patient and financial information in assigned area of responsibility. Other duties as requested or assigned.
Qualifications:
The ideal candidate for the position will have the following background and experience : High school diploma or equivalent required. Minimum of two (2) years in healthcare reimbursement, managed care or finance; or equivalent combination of education and work experience. Proficiency with computer systems and Microsoft Office (Word and Excel) required. Working knowledge of state, federal, and third party claims processing preferred. Must successfully complete required e-learning courses within 90 days of occupying position.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit and use hands to finger, handle, or feel. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 30 pounds. Requires vision and hearing corrected to normal ranges.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment and requires frequent interaction with corporate and practice staff and management. Work may require some travel by air or automobile, approximately 5% of time.
