What are the responsibilities and job description for the Certified Patient Account Rep position at Central Georgia Cancer Care, P.C.?
Job Description
Job Description
Patient Account Representative in a busy oncology practice obtaining prior authorization for scheduled testing and financial estimates for all services our providers deem medically necessary in the treatment of patient.
Job Summary
Patient Account Representative is responsible for securing prior authorization and financial estimates for scheduled testing and other ordered services prior to patient being appointed for receipt of services.
The Patient Account Representative is responsible for thorough and accurate documentation of services. The Patient Account Representative will assist in writing and revising letters to support necessity and appropriateness of services ordered, as needed.
This position must be able to work in a fast paced environment, must have exceptional communication skills both with patients, co-workers, physicians, and management.
Must have exceptional organizational skills and the ability to prioritize projects to maximize accuracy and completion of tasks in a timely manner.
Must be able to receive and provide constructive feedback and always open to suggestions for process improvement.
Essential Job Responsibilities
The Patient Account Representative’s job responsibilities include, but are not limited to :
1.Punctuality and attendance in the office are required.
2.Work with front office staff and nursing staff to secure precertification for scheduled testing and any other ordered services in accordance with prescribed protocols and organization guidelines.
3.Communicate effectively with insurance payers regarding patient benefits and coverage for ordered services prior to scheduling.
4.Complete Financial Estimates for all Chemotherapy, DMERC Oral Chemo, scheduled testing, and all other ordered services based on assigned provider and location.
5.Schedule Financial Counseling with patients to review estimation of costs for services, concerns regarding accounts, or to establish payment options.
6.Monitor daily schedules to ensure all insurance requirements have been met prior to service.
7.Communicate effectively through EMR for giving and receiving information pertinent to oncology patient care. Minimize disruption to patient care by following EMR protocol with phone call utilization for urgent matters.
8.Initiate / respond to precertification requests for services no later than two (2) business days from receipt of order from front office staff via EMR.
9.Timely create, refine, and maintain processes to allow for mostefficient approval of medical services for patients.
10.Provide Itemized Statements upon request.
11.Refer patients to Patient Assistance for financial assistance in theevent the patient is unable to meet financial obligation for treatment.
12.Collect due cost share (deductibles, coinsurance) from patients asrequired by payer contract.
13.MUST be Certified Patient Account Rep.
Other Job Responsibilities
Additional job responsibilities of the Patient Account Representative include, but are not limited to :
1.Maintain current knowledge of oncology principles and payer requirements.
2.Participate in process improvement projects as directed.
3.Demonstrate a commitment to improving the quality of patientexperience in regard to services being precertified and scheduled in atimely manner.
4.Collaborate with the front desk staff and billing department to seekcreative ways to solve patient care issues.
5.Update job knowledge by participating in educational opportunities;reading professional publications.
6.Enhancing practice reputation by accepting ownership foraccomplishing new and different requests; exploring opportunities toadd value to job accomplishments.
7.Comply with CGCC policy and procedures.
8.Educating, mentoring and training new PAR Staff as required.
9.Perform other duties as assigned.
Required Skills :
1.Must have strong communication skills in both verbal and writtenform.
2.Must exhibit a positive attitude and maintain productive workingrelationships within the organization.
3.Must have excellent organizational and time management skills.
4.Must be willing and able to learn, effectively utilize, and teach othersregarding CGCC equipment, software, and processes.
5.Must be able to maintain confidentiality and have the utmostprofessionalism.
6.Ability to work in a fast-paced environment.
7.Must be able to work within a team to complete work assignments.
Physical Demands : Physical demands of this position include but are not limited to : 1.Standing and walking2.Sitting3.Bending and stooping4.Pushing / pulling
Education / Experience :
1.High School Diploma or GED
2.Computer Experience, including but not limited to, practice management software, word processing and spreadsheet applications, and payer portal applications.
3.Must be Certified Patient Account Rep. Minimum two (2) years experience in a medical billing environment, with thorough knowledge of Utilization Management and / or patient collections;
Oncology experience preferred.
4.CPT, ICD-10 coding and medical terminology required