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Insurance Specialist
2 months ago
The US Oncology Network is seeking a highly skilled Insurance Specialist to join our team at Texas Oncology. This full-time position will be based in Austin, TX, and will support our Regional Business Office. The ideal candidate will have a strong background in medical billing and payment, with experience in payer and patient account balances, collections, and insurance resolution.
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.
- May refer patients to Patient Benefits Representative to set up payment plans.
- Maintain credit balances of patients and payors, ensuring timely refunds within government guidelines and regulations.
- Adhere to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient records.
- 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 position.
- CPC certification preferred.
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.
