A/R & Authorization Specialist - Not a Remote Position

2 weeks ago

Jacksonville, Florida, United States Cancer Specialists LLC Full time

Cancer Specialists of North Florida is recruiting for an experienced A/R & Authorization Specialist for our busy Radiation Department. This is not a remote position. The A/R & Authorization specialist holds a dual role and is responsible for obtaining and recording all authorizations needed for radiation treatment and services in addition to following up on Accounts Receivable for the Radiation department.

On the A/R side, this position is responsible for contacting insurance companies for non-payment of claims, submitting medical records as requested by the carrier, and overseeing and handling collections on patient accounts, as well as other related and assigned tasks.

Essential duties and responsibilities include the following: 

  • Run schedules to see if there are any radiation add-ons that require authorization
  • Call insurance companies for authorization obtainment and information
  • Coordinate with the physicist in updating any necessary changes to authorization requests
  • Retrieve written authorizations from insurance websites and portals
  • Enter authorizations and approvals in Mosaiq, and notate in Reg Overlay and in QCLs
  • Coordinate with physicians for peer-to-peer reviews, as required
  • Verify medical guidelines with insurance policies
  • Notate patient accounts with any pertinent information relating to authorizations
  • Perform review of patient accounts to ensure accuracy and timely payment per protocol
  • Demonstrate the ability to deal with patients and insurance companies in a professional manner regarding sensitive financial matters and recapture unpaid balances
  • Receive and resolve patient billing complaints and questions; initiates adjustments as necessary; follow up on all zero payment explanations of benefits and extend all options to obtain claim payments
  • Respond to all insurance company requests and provide information in a prompt and professional manner
  • Review EOBs (remittances) to ensure proper reimbursement of claims and report any problems, issues, or payer trends to supervisor
  • Interpret fee schedules and have ability to utilize to ensure proper payment receipt
  • Prepare adjustment requests with appropriate documentation and submit to supervisor
  • Work multiple A/R reports as provided by supervisor within specified timeframe
  • Request necessary information from site(s) and pertinent staff. Ability to follow up to assure receipt of information
  • Submit patient and insurance refunds for processing
  • Work credit balance reports for insurance and patient accounts
  • Work insurance and patient aging reports
  • Work correspondent letters from insurance companies requesting medical records
  • Maintain confidentiality regarding patient account status and the financial affairs of clinic and company
  • Attend seminars/meetings as needed
  • All other duties as assigned

Full-time position

Location Address: 7751 Belfort Parkway, Jacksonville, FL 32256

Education and Experience: 

  • High School Diploma or Equivalent
  • Minimum of two years of authorization and/or accounts receivable follow-up preferably in a medical and/or oncology setting

Compensation and Benefits:

  • Salary is commensurate with experience and qualifications

Cancer Specialists of North Florida is an "EEO Employer" and "Drug Free Workplace"

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