Accounts Receivable Insurance Specialist

7 days ago

West Palm Beach, Florida, United States Cancer Center of South Florida Full time $60,000 - $90,000 per year
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POSITION SUMMARY:

The Accounts Receivable Insurance Specialist handles insurance follow-up and account resolution for assigned payors to ensure timely reimbursement. Responsibilities include resolving billing issues, researching discrepancies, and addressing patient inquiries with a focus on service and communication. This role requires expertise in the revenue cycle, medical billing, and oncology-specific reimbursement guidelines.

CORE ESSENTIAL RESPONSIBILITIES:

  • Manage accounts receivable for assigned payors by analyzing and resolving denials, appealing rejected claims, and correcting billing discrepancies to ensure timely reimbursement.
  • Conduct consistent follow-up with insurance companies and address overdue claims across commercial and government payors.
  • Review EOBs to confirm accurate payments and report discrepancies or trends to leadership.
  • Maintain detailed documentation of collection efforts and resolution activities in EPIC using standard note format.
  • Handle patient billing inquiries, negotiate payment plans, and respond promptly to calls or correspondence.
  • Monitor and report credit balances; initiate appropriate refunds and write-offs with supporting documentation.
  • Collaborate with internal teams to communicate billing issues, share updates, and support resolution.
  • Verify patient insurance eligibility and benefits; understand payer-specific processes, including copays, deductibles, and coinsurance.
  • Stay current on oncology coding standards (HCPCS/ICD-10/CPT) and participate in training and compliance initiatives.
  • Support other revenue cycle functions as needed and perform additional duties as assigned.

Requirements:

EDUCATION & EXPERIENCE

  • High school diploma or equivalent required; associate degree in health sciences preferred.
  • Minimum 3–5 years of experience in medical accounts receivable, with oncology/hematology billing preferred.
  • At least 5 years' experience in private practice accounts receivable.

KNOWLEDGE, SKILLS OR ABILITIES

  • Proficient in medical billing and insurance reimbursement processes, including denial resolution and payer-specific guidelines.
  • Thorough understanding of ICD-10, CPT required and working knowledge of HCPCS and modifiers specific to hematology/oncology treatments preferred.
  • Proficient in using Epic or similar programs.

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