SCOPE: Under general supervision, performs all clerical, secretarial and data management functions of the PET department. Assists with all duties in regards to authorization, reimbursement and maintains relationships with other specialty providers involved in patient care. Initiates and/or maintains accurate logs of all patients referred for scans. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Obtains authorization from insurance carrier for all required/special services.
Works with PET Medical Director, PET Technologist, referring physicians, and sites to ensure that information is received on a timely basis.
Gathers and verifies all specialty billings. Maintains expense logs up to date for each case. Monitors accounts closely for correct billing and proper account setup for start and stop dates for case rate, including account follow up on all unpaid and incorrect paid claims.
Ensures complete and timely coding and entry of all patient charges associated with treatment on the charge sheets.
Assumes responsibility for proper encounter setup and pricing for optimum charge capture and proper account allocation, including secondary billing.
Monitors and updates changes made by insurance carriers to ensure correct billing and timely payments.
Conducts maintenance on dictation including review for accuracy before sending to appropriate recipients.
Works collaboratively with finance, administration, and program staff to refine billing tracking and collections systems and to prepare quarterly financial reports for program, finance, and administrative staff.
Maintains patient data files for easy retrieval and review. Prepares weekly patient tracking forms and submits electronically; distributes appropriately.
Provides initial triage of incoming phone calls to the PET program.
Qualifications: MINIMUM QUALIFICATIONS: High school diploma or equivalent. Minimum five years in one or more of the following areas: research assistance, medical transcription, medical assistance, medical record reimbursement/financial/business office in a health care setting. COVID-19 vaccination is required. We will consider accommodations for disability and religious based reasons.
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 experience prolonged sitting, some bending, stooping and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight correctable to 20/20. Requires occasional lifting of up to 30 pounds.
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. While performing the duties of this job, the employee is exposed to conditions typical in a medical office setting.