About the Role
Responsible for timely updating and adding current payer plan to the patient’s chart utilizing all available electronic tools, including making outgoing telephone calls to both patients and payers’ plans.
What You’ll Be Doing
Via electronic tools, update all requisite payer plan information, including subscriber and patient ID # within Urology of Indiana practice management system prior to the patient appointment.
Daily, run and work the Eligibility queue report per assigned locations.
Monthly, run patient aging report and review accounts to identify, add and/or update any missing or incorrect insurance.
If previous claims were filed with an invalid payer plan, add correct payer; change status and owner on the claim and rebill all of the claims.
Apply patient alert on chart “Front desk- please task new insurance card”.
When changing insurance in iSALUS if the appointment type is at a hospital (inpatient/outpatient), send via email to the surgery scheduler or precert team member to advise them of the change.
In the event eligibility cannot be confirmed via available tools, contact (via telephone) the patient.
If no response from patient within three business days, send the patient an insurance information letter and apply an alert to the patient’s chart (prompts front office to task new insurance card.) Expire the alert in 7 days.
If Medicare plan is on the patient chart, verify or add the new MBI number.
Handles inbound calls from locations, patients, etc. with general insurance questions.
Back up to charge entry and payment posters.
Responsible for mail distribution, faxes, copies, scanning and E-doc process.
Provide benefits estimates for patients’ procedures.
Other duties as assigned
What We Expect from You
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Knowledge of medical terminology
Understanding how to interpret commercial payer’s, Medicaid and Medicare’s benefits and eligibility information on all of the respective payer’s websites.
Good organization and strong follow through skills.
Ability to respond to questions in a tactful and professional manner.
Detail-oriented- must pay attention to details.
Ability to maintain confidentiality.
Education and/or Experience
High school diploma or three to five years related experience and/or training in collection of medical accounts; or equivalent combination of education and experience.
Knowledge of insurance regulations and procedures. Experience with CPT-4 and ICD-10 is preferred.
Language Skills
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine correspondence. Ability to speak effectively before individuals or groups of people.
Mathematical Skills
Ability to calculate basic figures and amounts. Ability to apply concepts of basic algebra and geometry.
Reasoning Ability
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Computer Skills
To perform this job successfully, an individual should have knowledge of basic computer software.
Other Skills and Abilities
Strong written and oral communication skills
Demonstrate a positive, cooperative and professional attitude towards co-workers and public.
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 frequently required to stand; walk; sit; use hands to finger, handle, or feel; reach with hands and arms; stoop, kneel, crouch, or crawl and talk or hear. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Position Type/Expected Hours of Work
This is a full-time position. Days and hours of work are Monday through Friday, approximately 8 hours per workday. Occasional evening and weekend work may be required as job duties demand.
What We are Offer You
At U.S. Urology Partners, we are guided by four core values. Every associate living the core values makes our company an amazing place to work. Here “Every Family Matters”
Make Someone’s Day
Achieve Possibilities Together
Treat people with dignity
Do the right thing
Beyond competitive compensation, our well-rounded benefits package includes a range of comprehensive medical, dental and vision plans, HSA / FSA, 401(k) matching, an Employee Assistance Program (EAP) and more.
About US Urology Partners
U.S. Urology Partners is one of the nation’s largest independent providers of urology and related specialty services, including general urology, surgical procedures, advanced cancer treatment, and other ancillary services. Through Central Ohio Urology Group, Associated Medical Professionals of NY, Urology of Indiana, and Florida Urology Center, the U.S. Urology Partners clinical network now consists of more than 50 offices throughout the East Coast and Midwest, including a state-of-the-art, urology-specific ambulatory surgery center that is one of the first in the country to offer robotic surgery. U.S. Urology Partners was formed to support urology practices through an experienced team of healthcare executives and resources, while serving as a platform upon which NMS Capital is building a leading provider of urological services through an acquisition strategy.
U.S. Urology Partners is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, veteran status, sexual orientation, genetic information, arrest record, or any other characteristic protected by applicable federal, state or local laws. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.
