Insurance Specialist

1 week ago

Cedar Park, Texas, United States Texas Oncology Full time
Overview

The US Oncology Network is seeking a highly skilled Insurance Specialist to support our Regional Business Office location in Austin, TX. This full-time position will work in a hybrid remote environment, supporting our team with a focus on payer and patient account balances.

Responsibilities
  • Monitor delinquent accounts and perform collection efforts with payers.
  • Identify trends with payors and report to leadership in a timely manner.
  • Attend payor calls with regional representatives for collaborative resolution.
  • Prepare comprehensive appeals to resolve denials with insurance companies.
  • Review reports, research, and resolve issues.
  • Review payment postings for accuracy and ensure account balances are accurate.
  • Work with co-workers to resolve insurance payment and billing errors.
  • Monitor and update delinquent accounts status.
  • Recommend accounts for collection or write-off.
  • Contact patients to secure past due balances, verify patient demographics and insurance providers, update information in systems, and document conversations.
  • Maintain credit balances of patients and payors, ensuring timely refunds within government guidelines and regulations.
Requirements
  • High School diploma or equivalent required.
  • Minimum two (2) years combined medical billing and payment experience required.
  • Demonstrate knowledge of state, federal, and third-party claims processing required.
  • Demonstrate knowledge of state and federal collections guidelines.
  • Must successfully complete required e-learning courses within 90 days of occupying the position.
  • CPC certification preferred.
Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit and use hands to manipulate a computer keyboard and mouse. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 30 pounds. Requires vision and hearing corrected to normal ranges.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work is performed in an office environment. Involves frequent contact with staff. While performing the duties of this job, the employee is regularly exposed to direct contact with patients with potential for exposure to blood, toxic substances, ionizing radiation, and other conditions common to a clinic environment.

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