Outpatient Business Coordinator-PRMC - CANCER CENTER

Summary:
All functions dealing with collecting, admitting, coding, and Managing all activities to insure maximum reimbursement for PRCC patients

Type of Opportunity: Full Time
FTE: 0.900000
Exempt: No
Work Schedule: Days

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Other information:
High school plus specialized, short-term training in computers. One to three years experience in medical office and /or one to two years of experience with admitting/coding/registration/patient billing.

Education:
Essential:
* High School Diploma or GED

Responsibilities:
Financial counselor and Accounts Manager

*Coordinates the admission process for the patient including registration, insurance verification, co-pay/co-insurance collection, and financial arrangements.

*Collect identified patient financial obligation, arrange method of payment, advise patients regarding insurance coverage and benefits, and resolve account as per PHS guidelines to include assisting the patient with third party resources for hospital payment.

*Ensures that all aspects of the registration/admitting process is complete for every registration and the information obtained is accurate and meets the overall standard set by the hospital..

*Verifies insurance coverage, verifies claim mailing address, subscriber, group, obtains the needed authorizations/referrals, and follows up to ensure timely correct filing by working with the central billing office for any needed changes or corrections.
*Maintains up-to-date financial records for re-occurring patients. Discharged and readmitting patients as treatment ends, insurance changes, and authorizations have lapsed. Coordinating with medical staff account number changes and what is authorized by the insurance company.

*Daily review of patient accounts to ensure authorizations are in place for treatment as well as keep the authorization current, according to the patient s treatment regimen.

*Post payments to patient accounts, balance and reconcile daily monies collected with totals posted.

*Review incomplete medical record report for any patients that are lacking a diagnosis and physician signature to ensure compliance with PHS and Medicare guidelines.

*Keep current on all reimbursement billing procedures of third party and private insurance payers.

*Reconcile Medipac reports to billed charges report.

*Responsible for Payrollmation entries for payroll.

*Initiate and receive calls pertaining to patients accounts.

*Key all payment and relevant information to appropriate patient accounts.

*Keep up to date with FDA approval of drugs and treatments to ensure proper reimbursement. Research the drugs that are given to know the dates of authorization and treatments used for, relay the information to the insurance company to assist with system updates. Obtain authorization for experimental treatments by providing the insurance company information on drugs and treatment process in collaboration with healthcare provider.

*Accept responsibility for continuing education to improve work efficiency

Administrative Staff Support

*Review and initiate proper actions pertaining to correspondence.

*Assemble, prepare, and distribute relevant information to the appropriate individual(s) to facilitate further processing.

*Coordinate facility requests for problems with heating, cooling, plumbing, and other maintenance issues, such as ordering repairs for copiers.

*Maintain accurate inventory of office supplies.

*Coordinate projects as they arise. (i.e. Customer Satisfaction Survey).

*Responsible for collection and distribution of mail and memos from assigned staff.

*Creates and maintains Access database and Excel reports.

*Provide documentation of scheduled appointments, procedure instructions and location directions.

*Pulls charts and films and documents all necessary information on expired patients charts.

*Responsible for physician scheduling log, check for coverage, accuracy and timing of procedures.

*Accesses several systems such as Pathology and Lab Systems via the computer to research the medical record when needed to complete the coding in a timely manner.

We offer more than the standard benefits!

Presbyterian employees gain access to a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more!

Learn more about our employee benefits:

Why work at Presbyterian?

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.

Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans.

About Presbyterian Healthcare Services

Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

About Our Regional Delivery System

Presbyterian's Regional Delivery System is a network of six hospitals and medical centers throughout rural New Mexico including locations in Clovis, Espanola, Ruidoso, Santa Fe, Socorro and Tucumcari. Our regional facilities are home to more than 1,600 clinical and non-clinical employees who help make Presbyterian the state's largest private employer with nearly 14,000 statewide employees. With a variety of services ranging from general surgery to pediatrics to heart and cancer care, our regional employees are proud to provide close-to-home care for their communities.

We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.

About New Mexico

New Mexico continues to grow steadily in population and features a low cost-of living.

Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture - from mountains, forests, canyons, and lakes, to caverns, hot springs and sand dunes.

New Mexico offers endless recreational opportunities to explore and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.