Medical Billing Specialist

Beverly Hills Oncology Me•Beverly Hills, CA

13d•$24 - $30

About The Position

The Medical Billing Specialist supports patient access and financial operations at Beverly Hills Cancer Center. The role verifies insurance eligibility and coverage, manages prior authorization requests and renewals, reviews authorizations, and accurately records information in the electronic medical records system. It also determines patient financial responsibility, researches demographic information, and communicates with patients about denied authorizations, pre-determinations, waivers, and advance beneficiary forms. The specialist provides patient financial counseling, explains and helps patients enroll in available financial assistance programs, establishes and monitors payment plans, prepares daily collection statements, and posts and reconciles patient payments. The role coordinates patient care by scheduling appointments as needed and works with other departments on authorizations and appeals. Beverly Hills Cancer Center is a private comprehensive cancer treatment facility in Los Angeles that provides oncology, infusion, diagnostic imaging, laboratory, and clinical trial services.

Requirements

High school diploma required.
At least two years of patient front-office and/or billing experience, including knowledge of insurance verification and authorization processes.
Familiarity with medical authorization processes for different types of medical insurance, including accessing health plan portals.
At least one year of patient financial counseling experience.
Excellent computer skills and EMR knowledge.
Excellent verbal and written communication, customer service, and problem-solving skills.
Ability to multitask, work independently, and problem-solve.

Nice To Haves

Associate or bachelor's degree.
Exposure to an oncology and/or imaging setting.

Responsibilities

Verify insurance eligibility and coverage, identify coverage limitations, and obtain required authorizations.
Receive and monitor prior authorization requests according to company standards.
Collaborate with other departments to obtain prior authorizations and pursue appeals.
Proactively follow up on prior authorizations approaching expiration.
Verify insurance for new and current patients, review incoming authorizations, and accurately enter information into the EMR.
Determine patient financial responsibility based on insurance information.
Research and verify patient demographic information using online verification systems.
Communicate with patients when authorizations are denied or pre-determination is required, and monitor when waivers and advance beneficiary forms are needed.
Collect and post copayments and outstanding balances.
Provide patient financial counseling, maintain knowledge of financial assistance programs, and educate patients and assist with enrollment.
Establish patient payment plans according to applicable policies.
Prepare daily patient collection statements and meet with patients who have outstanding balances.
Prepare and monitor payment plan agreements and advise the supervisor of collection issues.
Post and reconcile daily patient payments received through the front desk using practice management and EMR systems as directed.
Communicate effectively with physicians, employees, patients, and families from diverse populations.
Multitask, work independently, and solve problems while supporting a positive patient experience.
Coordinate patient care, including scheduling appointments as needed.