Medical Account Auditor

Employment: Account Auditor

Type: Full Time

Location: 1140 Business Center St 580, Houston Tx 77043, TX

"You can make a difference in the life of an oncology patient and find your career satisfaction by joining our team of healthcare professionals today."

About Oncology Consultants

Oncology Consultants has been a premier adult medical oncology & hematology practice in Houston, TX for over 40 years. Our healthcare team is committed to provide state of the art cancer treatment in a caring environment as we continue to expand our oncology services in the metropolitan region.

About the Position

The primary responsibility is to review and audit patient accounts to ensure proper claims/charges, payments and adjustments are completed to resolve patient account review requests. All patient account review requests will be reviewed and resolved. This position requires independent through review of the patient account activities and when needed work with appropriate parties/departments. Tasks include but are not limited to research and review of daily transaction batches for discrepancies and fee schedule issues. The Patient Account Auditor works closely with the Revenue Cycle Management, Charge Reviewers, Payment Posters, Collectors, Prior Authorization and Eligibility/Verification team.

Shift Schedule:

• Mon - Fri: 8am - 5pm

Benefits:

• Insurances: Life, medical, dental, short term and long-term disability
• 401K
• Free parking
• PTO
• Holidays
• Competitive salary
• Employee Assistant Program
• Tuition Reimbursement
• Continuing Medical Education Allowance
• Pet Insurance

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Audit and review transaction batches for any discrepancies
• Identify any fee schedule issues and work with contracting to resolve
• Work with appropriate parties to maintain accounts (collectors)
• Serve as the middle party between patient, insurance and contracting needs
• Keep upper management aware of payer trends

QUALIFICATIONS:

• Review and Audit patient account inquires - current patient account balance/financial responsibilities.
• Responsible for handling secondary claim errors - due to balancing, payment, adjustment posted from Primary Insurance explanation of benefits.
• Ability to Identify issues, research, and work with appropriate departments to obtain the most optimal resolutions.
• Serve as an advocate for patients.
• Ability to track and trend issues and report to Management.
• Ability to handle ad-hoc assignments and projects.

EDUCATION and/or EXPERIENCE

• Strong knowledge of Revenue Cycle Management including but not limited to:

1. Eligibility/verification
2. Prior Authorization
3. Charge Entry
4. Payment Posting
5. Collections
6. Contracting
7. Fee Schedules
8. Patient Statement

• Understanding of Payer/Insurance Carriers, the differences of type of plans/products offered
• Knowledge of current Medical/clinical guidelines such as: NCD, LCD and Insurance Carrier specific medical/clinical guidelines.
• Strong verbal and written communication skills.
• Problem solving skills.
• Ability to prioritize, multitask and maintain accuracy .

Oncology Consultants is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

PHYSICAL DEMANDS: Requires sitting and standing associated with a normal office environment. Manual dexterity needed for using a calculator and computer keyboard. This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, skills and working conditions may change as needs evolve.

COMMENTS: This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.

Medical Center | Memorial City | Sugar Land | Katy | Willowbrook | Southwest Northwest |League City | Pearland |Precision | Pasadena | Cypress | Corpus Christi

Apply today. Our short application process takes less than 5 minutes with your phone, tablet or computer.