Entry Level Risk Adjustment Coder Jobs in Leander, TX

The US Oncology Network/Texas Breast Specialists is looking for a Patient Services Representative to join our Breast Surgery team!

This position entails working at various Texas Breast Specialists sites such as North Austin, Georgetown, and Cedar Park. Typical work week is Monday through Friday 8am - 4:30pm with no weekends or major holidays!

This position can be a level 1, 2, or Sr based on candidate experience.

Notes from the hiring manager: At Texas Breast Specialists, you'll have the exciting opportunity to collaborate with a team of highly qualified breast surgeons and their compassionate staff. Together you'll provide exceptional patient care to individuals facing both malignant and benign breast disease. Join us is making a meaningful impact on patients' lives while working in a supportive and dynamic environment.

As a part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas, our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today-at Texas Oncology, we use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve "More breakthroughs. More victories." in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis.

The US Oncology Network is one of the nation's largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.

What does the Patient Services Representative do?

Under direct supervision, performs general business office functions that may include some or all of the following: billing and claim submissions; charge capture and payment posting; insurance verification and eligibility; obtaining pre-authorization; counseling patients and families on insurance and payment issues; and account follow-up and payment resolution. As necessary, assists patients and families with obtaining community resources including, but not limited to, housing, transportation, and financial support. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.

The essential duties and responsibilities (including but not limited to):

• Ensures all insurance, demographic, and eligibility information is obtained from patients and entered into the system in an accurate and timely manner. Registers patients in the system as necessary.
• Collects and reviews all patient insurance information and completes insurance forms. Collects co-pays, deductibles and other out of pocket amounts at the time of visit.
• Confirms patient insurance verification and eligibility. Obtains pre-authorization of services and/or referrals. Assesses patient financial requirements and advises patients and families on insurance benefits, co-pays and financial obligations.
• Posts line items and adjustments to patient accounts. Balances receipts, reconciles daily work batches and prepares audit trail. Prepares deposits for bank as needed.
• Reviews Explanation of Benefits (EOB) for consistency.
• Submits files and processes all claims for payment. Researches and resolves claim delay issues.
• Resolves patient questions and complaints regarding insurance billing and adjusts accounts as necessary. Resubmits claims and processes all insurance/patient correspondence. Provides all documentation to expedite payment.
• Follows-up on assigned accounts. Uses collection techniques to keep accounts current including monitoring for delinquent payments.
• Sets-up financial arrangements with patients as necessary.
• As necessary, assists patients with researching and obtaining community resources including housing, transportation, drugs and pharmaceutical supplies, and financial resources.

The ideal candidate for the Patient Services Representative will have the following background and experience:

Level 1

• High School Diploma or equivalent required.
• This position is entry level and requires 0-3 years of medical business office experience.

Level 2 (in addition to level 1 requirements)

• Minimum 3 to 5 years medical business office experience.

Level Sr (in addition to level 1 and 2 requirements)

• Minimum five years medical business office experience.

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 sit and use hands to finger, handle, or feel. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 30 pounds. Requires vision and hearing corrected to normal ranges. Requires vision and hearing corrected to normal ranges.

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. Work requires frequent interaction with patients and staff.