Billing Representative- Oncology

Overview

Schedule:

Full-time Days:
Monday - Friday.

Location:

Grosse Pointe Woods, MI - has potential to be hybrid after training. Department:
Outpatient Oncology Clinic.

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.

• 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.

• High School diploma equivalency OR 1 year of applicable cumulative job specific experience required
• Medical insurance and billing experience required

• Organization:
  Henry Ford Health St. John Hospital
• Department: GLCMS VECC Oncology
• Shift: Day Job
• Union Code:
  Not Applicable