Location:

Woodlands Cancer Institute

Pay Range:

$15.83 - $26.38

Position Summary: 

The primary responsibilities of Radiology Services Specialist (RSS) is to provide quality customer service and financial guidance.  Greeting the patient, collecting demographics including insurance and scheduling appointments are daily duties.  RSS is responsible for obtaining/managing prior authorizations required for all on site radiology services.  Acts as the liaison between the patient and the practice by communicating financial responsibilities to our patients and ensures benefits are documented in the EMR and billing software. Serves as the liaison between the patient and the practice by coordinating payments, assistance, monitoring patient balances, and streamlining communication of the financial responsibilities of our patients. Ensures the patients’ insurance benefits are kept up to date in the electronic medical records (EMR) and billing software while also verifying the patient’s services meet insurance coverage appropriateness.

Key Performance Areas:  All

• Responsible for scheduling Radiology appointments and maintaining all future schedules to adhere to radiology scheduling criteria.

• Accurately and promptly check-in patients per clinic policy, collect and document payments, verify demographic information including identification, chart photo and insurance.

• Prepare the clinic daily close deposit and documents.

• Monitors and coordinates internally and externally with the insurance company on the pre-certification and prior authorization processes, including peer-2-peer and appeals, seeking support from provider or pharmacy team when applicable.

• Review scheduled visits and identify if insurance benefit coverage is active and patient fiscal responsibility to be reviewed with patient explaining insurance benefits and fiscal responsibility. All unplanned exceptions are to be communicated to provider immediately.

• If applicable, obtain necessary information from patient for assistance income guidelines.

• Explain forms and paperwork needed such as waivers, treatment estimates.

• Communicate openly and routinely throughout the course of the workday with providers, nursing staff, PSS staff, UM team and coworkers through Teams, phone calls, emails and in person to discuss fiscal responsibility and other items as needed.

Job Duties:

• Provide support and understanding to our patients and their caregivers to create a friendly and welcoming environment.

• Graciously answer telephones promptly and route calls or document messages including voicemails as appropriate within the EMR. Activate and deactivate the answering service as required for clinic hours. Must understand and follow the policy for emergency calls

• Perform the tasks of other patient services specialist stations that employee has been trained on. Will be expected to cover other stations for absences, lunches, vacations, etc.

• Comply with all Federal and State laws and regulations pertaining to patient care, patients’ rights, safety, billing, privacy and collections.  Adhere to all AON and departmental policies and procedures, including IT policies and procedures and disaster recovery plan.

• Assist in training other AON employees.

• Keep work area and records in a neat and orderly manner.

• Maintain all company equipment in a safe and working order.

• Maintain and ensure the confidentiality of all patient and employee information at all times in accordance to policy and HIPAA regulations.

• Will be expected to work at any AON location to help meet AON business needs. 

• Work closely with outside entities to ensure full collaboration and completion of forms and items needed in a timely and sometimes urgent manner.

• Assist patient(s) with completing necessary paperwork for assistance and other grant funded programs in order to secure financial aid for treatment and services.

• Have an understanding of patient assistance programs and grant services processes to ensure adequate application, placement, and coordination with financial aid counseling team.

• Understand and comply with all Federal and State laws and regulations pertaining to patient care, rights, safety, billing, and collections.

Required Qualifications: 

Education:   High school Diploma or GED required.  Further education or degree a plus

Experience:

• A minimum of two-years prior experience in the healthcare field required, preferably in a Radiology clinic. Patient financial background.

• Patient/Customer focused.   Prior Medical terminology required ICD9, ICD10 and CPT codes.

• Prior experience verifying patient Medical insurance.

• Prior experience verifying pre-certification and/or prior authorization with medical insurance.

• EMR background required.

• Prior Cash handling and monetary collection experience.

• Experience calculating and collecting patients’ responsibility and insurance co-pay/coinsurance.

• Excellent proven verbal and communication skills needed.

• Attention to detail with strong ability to multitask.

• Excellent interpersonal skills.  

Core Capabilities:

• Analysis & Critical Thinking: Critical thinking skills including solid problem solving, analysis, decision-making, planning, time management and organizational skills. Must be detailed oriented with the ability to exercise independent judgment.

• Interpersonal Effectiveness: Developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness. Ability to work effectively with sensitive and confidential material and sometimes emotionally charged matters.

• Communication Skills: Good command of the English language. Second language is an asset but not required. Effective communication skills (oral, written, presentation) is an active listener, and effectively provides balanced feedback.

• Customer Service & Organizational Awareness: Strong customer focus. Ability to build an engaging culture of quality, performance effectiveness and operational excellence through best practices, strong business and political acumen, collaboration and partnerships, as well as a positive employee, physician and community relations.

• Self-Management: Effectively manages own time, conflicting priorities, self, stress, and professional development. Self-motivated and self-starter with ability work independently with limited supervision. Ability to work remotely effectively as required.  

• Must be able to work effectively in a fast-paced, multi-site environment with demonstrated ability to juggle competing priorities and demands from a variety of stakeholders and sites.

• Computer Skills:

  • Proficiency in MS Office Word, Excel, Power Point, and Outlook required.

Travel: 0%

Standard Core Workdays/Hours: Monday to Friday 7:30 AM – 4:30 PM.  Occasional overtime may be required, and weekend shifts based on location hours and operational needs.

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