Billing Representative- Oncology- Full Time

GENERAL SUMMARY

• Department: Outpatient Oncology Clinic
• Schedule: Full-time Days: Monday - Friday
• Location: Grosse Pointe Woods, MI- has potential to be hybrid after training

Determines and verifies insurance coverage and coordination of benefits from all sources for assigned area. Ensures proper adequate and timely billing to ensure prompt payment.

Responsibilities:

• Confirms insurance coverage. Determines necessity for pre-authorization and obtains authorization for scheduled procedures.
• Determines financial responsibility for services to be provided. Notifies patients and/or practitioners of any services requested and/or referred that are not authorized by insurance.
• Communicates with patients and practitioners regarding financial responsibility and insurance coverage issues.
• Maintains detailed documentation in the patient account record of all billing activities. Maintains documentation of claims processed as part of the daily claims reconciliation process.
• Prepares and completes claims for commercial insurance companies, third party organizations and/or government or self payers.
• Researches, analyzes and reconciles Medicare/Medicaid billing and reimbursement practices.
• Maintains detailed documentation in the patient account record of all billing activities. Maintains documentation of claims processed as part of the daily claims reconciliation process.
• Consults with appropriate parties to resolve unbilled claims. Reviews recent accounts for proper billing practices and reimbursement.