Job Description

ABOUT AUSTIN REGIONAL CLINIC:

Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas’ largest professional medical groups with 35+ locations and we are continuing to grow. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance, Development and more. For additional information visit https://www.austinregionalclinic.com/careers/

PURPOSE

Prepares estimates for medical services prior to treatment, educates patients and collects payment when appropriate. Works with Infusion Coordinator Supervisor to ensure all charges and benefits are applied correctly for patient for infusion medications. Carries out all duties while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization.

ESSENTIAL FUNCTIONS

Senior Infusion Financial Counselor

• Utilizes Medical Present Value’s Patient Responsibility Pricer application to prepare estimates for medical services. Obtains appropriate eligibility and benefits information and, together with the contractual allowable data, creates estimates.
• Contacts patients to provide a verbal estimate and attempts pre-collection of the patient responsible amount. Advises patient that the estimate may not reflect all charges as they vary based on services provided. Educates patients on their financial responsibilities.
• Mails a formal copy of the estimate and a letter to the patient. Documents details in account notes.
• If patient is present for estimate creation, obtains Patient’s signature on estimate and attempts to collect patient responsible mount.
• Maintains file copies of estimates.
• Returns telephone calls within timeframes established by department.
• Interacts with providers’ office and the billing office staff.
• Responsible for reviewing and submitting correct claims for infusion services to insurance payors.
• Assists patients in obtaining pharmaceutical assistance for infusion medications.
• Prepares and posts insurance EOBs for reimbursement from assistance plans, and posts EFT payments into Epic.

Customer Service

• Receives inbound telephone calls from internal and external customers. ie. Patients, Insurance Representatives.
• Asks appropriate verification questions prior to releasing confidential patient information in accordance to company policy/HIPAA guidelines.
• Reviews explanation of benefits documents with knowledge and ability to explain information to patients/customers.
• Provides financial counseling service/payment arrangements to walk-in patients with outstanding account balances.
• All actions are documented with clear and accurate documentation in the Account Notes.
• Receives patient refund request information and forwards to Refunds processing..

Account Transactions/Insurance

• Reviews account transactions for accuracy.
• Uses appropriate transaction and ANSI codes per Posting guidelines.
• Reviews and documents patient correspondence. Contacts patients to acknowledge receipt of correspondence in a timely manner, whenever necessary.
• Obtains updated insurance information and forwards to the Registrations unit for eligibility verification.
• Utilize Payor Websites efficiently and maintain confidential security passwords.

Collections

• Receives credit card payments via telephone and posts payment accordingly.
• Establishes payment plans per Payment Agreement guidelines.
• Works closely with Collections Department and/or directly with Customers on payment of balances due.
• Sets up accounts with payment plan information and clearly documents the terms of the agreement.
• Consults with Supervisor prior to offering discounts for non-covered services.
• Meets 1106 collections expectations.

Other

• Performs all of the tasks of the PSC and Sr. PSC as needed or assigned.
• Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct.
• Regular and dependable attendance.
• Follows the core competencies set forth by the Company, which are available for review on CMSweb.
• Works holiday shift(s) as required by Company policy.

OTHER DUTIES AND RESPONSIBILITIES

• Assists supervisor with disputed accounts which may require additional follow up and/or rework.
• Keeps complete, accessible, and current Payor information.
• Provides assistance to coworkers as requested and/or necessary.
• Responds professionally and effectively to questions from external sources, i.e., customer or carrier, and internal sources, i.e., provider or management team.
• Attends required inservices/training sessions/department meetings.
• Meets performance competency standards for Registrations and Patient Accounts.
• Performs other duties as assigned

QUALIFICATIONS

Education and Experience

Required: High school diploma or GED. Two or more years of infusion medical billing experience. Experience with CPT and ICD coding.

Preferred:. Some higher education. Bilingual in English/Spanish.

Knowledge, Skills and Abilities

• Must have knowledge of legislative and private sector third party regulations and guidelines.
• Must have excellent verbal and written communication skills in order to communicate clearly and effectively to all levels of staff and the public.
• Ability to sit for extended periods of time at a computer workstation.
• Ability to engage others, listen and adapt response to meet others’ needs.
• Ability to align own actions with those of other team members committed to common goals.
• Excellent computer and keyboarding skills, including familiarity with Windows.
• Excellent verbal and written communication skills.
• Ability to manage competing priorities.
• Ability to perform job duties in a professional manner at all times.
• Ability to understand, recall, and communicate, factual information.
• Ability to understand, recall, and apply oral and/or written instructions or other information.
• Ability to organize thoughts and ideas into understandable terminology.
• Ability to apply common sense in performing job.

Work Schedule: Monday- Friday 8AM-5PM