Patient Advocate

Peninsula Radiation; Tyler (TX); Hybrid; USD 42,000 - 66,000; Full time

Job summary

Peninsula Radiation is seeking a Patient Advocate to manage the billing cycle for assigned client sites by working the 4 C’s: Charges, Claims, Cash, and Collections to achieve Gold Standard Results. Responsibilities include reviewing charges for accuracy, submitting clean claims, posting and reconciling payments, and resolving insurance and patient accounts receivable to payment resolution.

The role requires mastery of radiation oncology billing and Power BI, plus strong communication and ENCORE

Qualifications

• Mastery of radiation oncology-specific procedure codes, terminology, payer trends and billing requirements
• Proficient in Microsoft Office Suite and related software
• Experience in healthcare billing and patient accounts receivable processes
• Strong communication skills and ability to handle multiple tasks
• Demonstrates ENCORE values in communications

Responsibilities

• Demonstrates mastery of radiation oncology-specific procedure codes, terminology, payer trends and billing requirements
• Mastery of Power BI
• Perform daily review of charges queued to go out to third party payers for clean claim submission
• Post incoming insurance and patient payments daily and ensure payments reconcile to client(s)
• Manage AR by working denials and delinquent insurance balances
• Evaluate, prioritize, and perform AR follow-up work through phone calls, appeals, claim corrections and re-files as needed to resolve A/R balances
• Document accurate collection activity for reporting and tracking
• Knowledge of insurance plans and patient payment options available
• Understands how to read the patient’s ledger and correct reassignment of coinsurance, co-payments, and deductibles to the patient
• Answer incoming calls on or before the third ring
• Follows patient balance protocol and provides support with patient questions, and requests and assists patients with creating payment plans and/or taking credit card payments
• Gather, analyze, and communicate monthly accounting summaries and closing reports for management and client review and communicate to client in a timely manner
• Familiarity with RBS Revenue Cycle Structure - Clients and Physicians
• Stays current on training processes and developments within the company
• Demonstrates deep understanding of process reviews and comes up with innovative ideas
• Perform additional duties as assigned by management

Skills

Power BI

Communication

Attention to detail

Problem solving

Education

High School Diploma

Tools

Microsoft Office Suite

Job description

Description

The Patient Advocate is responsible for effectively managing the billing cycle for assigned client site(s) by working the 4 C’s: Charges, Claims, Cash, and Collections to achieve Gold Standard Results. Accountable for reviewing charges for accuracy, submitting clean claims, posting and reconciling payments, and resolving insurance and patient accounts receivables to payment resolution.

The Patient Advocate must be able to handle multiple, simultaneous tasks effectively and efficiently and is expected to demonstrate ENCORE in all communications.

Essential Duties and Responsibilities

• Demonstrates mastery of radiation oncology-specific procedure codes, terminology, payer trends and billing requirements


• Mastery of Power BI


• Perform daily review of charges queued to go out to third party payers for clean claim submission.


• Post incoming insurance and patient payments daily and ensure payments reconcile to client(s)


• Manage A/R by working denials and delinquent insurance balances


• Evaluate, prioritize, and perform A/R follow-up work through phone calls, appeals, claim corrections and re-files as needed to resolve A/R balances


• Document accurate collection activity for reporting and tracking


• Knowledge of insurance plans and patient payment options available


• Understands how to read the patient’s ledger and correct reassignment of coinsurance, co-payments, and deductibles to the patient.


• Answer incoming calls on or before the third ring


• Follows patient balance protocol and provides support with patient questions, and requests and assists patients with creating payment plans and/or taking credit card payments


• Gather, analyze, and communicate monthly accounting summaries and closing reports for management and client review and communicate to client in a timely manner


• Familiarity with RBS Revenue Cycle Structure - Clients and Physicians


• Stays current on training processes and developments within the company


• Demonstrates deep understanding of process reviews and comes up with innovative ideas


• Perform additional duties as assigned by management

Other Expectations/Skills

• A collaborative approach to assisting clients and staff.


• Self-motivated with the ability to solve problems.


• Reliable and extremely trustworthy.


• Ability to maintain confidential and meticulous records.


• Excellent verbal and written communication skills.


• Proficient in Microsoft Office Suite or related software.


• Exceptional organizational skills and attention to detail.


• Adaptability and willingness to remain flexible when changes occur


• Exhibit ENCORE values

Key Attributes

ENCORE Values

Encourage others’ success

New ideas; anticipate problems

Create financial value for our clients

Ownership towards a solution

Reach Life Balance

Embody a positive approach

Requirements

• High School Diploma.


• 1+ years of healthcare billing experience preferred.


• Medical Oncology experience preferred.

Physical Demands and Work Environment: The physical demands described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the functions.

• Ability to lift/carry up to 25 pounds.


• Ability to sit/stand for long periods of time.


• Good manual dexterity with the ability to perform repetitive hand/wrist motions.


• Requires mastery of complex language, comprehension, reasoning, and analytical skills typically found in mid to high-level work.


• Typical office environment


• Moderate noise levels

Disclaimer: This job description in no way states or implies that these are the only duties to be performed by the employee(s) of this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities.

The company is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.