Eligibility Specialist II

The US Oncology Network•Richardson, TX

10d•Hybrid

About The Position

The US Oncology Network is looking for an Eligibility Specialist to join our team at Texas Oncology! This full time hybrid remote position will support our Central Business Office location. Additionally, it is desired that the candidate reside within a commutable distance to the Central Business Office location. This position can be either a level 1, 2 or Sr based on candidate experience. 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.

Requirements

High school diploma or equivalent required.
Proficiency with computer systems and Microsoft Office (Word and Excel) required.

Nice To Haves

Associates degree preferred.

Responsibilities

Researches and obtain accurate and current insurance coverage information, makes corresponding corrections in the PMS.
May evaluate benefits and eligibility to assess patient financial responsibility.
May coordinate referral from primary care clinic to ensure appropriate authorizations are secured and entered into the PMS.
Identifies uninsured patients and refers to patient benefit representative for coordination of payment.
Communicates system issues and/or payor trends lead or supervisor.
May answer questions and resolve complaints.
Documents conversations with payors in the PMS.
Contacts and follows up with clinic or any missing or incomplete documentation.
Works TES Edits.
Researches and responds to routine account inquiries and takes appropriate action; escalates non-routine issues.
Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient’s records and collections.
Other duties as requested or assigned.