[Hiring] Insurance Specialist @The US Oncology Network

Role Description

Regional Cancer Care Associates (RCCA) is seeking a detail-oriented and motivated Insurance Specialist to join our growing team. In this vital role, you will help ensure patients receive the care they need by supporting accurate billing, timely payments, and exceptional service.

Qualifications

• High School diploma or equivalent required
• Minimum four (4) years combined medical billing and payment experience required
• Demonstrate knowledge of medical coding, preferably oncology coding
• Demonstrate knowledge of state, federal, and third party claims processing required
• Demonstrate knowledge of state & federal collections guidelines
• Must successfully complete required e-learning courses within 90 days of occupying position

Requirements

• Monitors delinquent accounts and performs collection duties
• Reviews reports, identifies denied claims, researches and resolves issues, may perform a detailed reconciliation of accounts, and resubmits claim to payer
• Reviews payment postings for accuracy and to ensure account balances are current
• Works with co-workers to resolve payment and billing errors
• Monitors and updates delinquent accounts status
• Recommends accounts for collection or write-off
• Verifies existing patients have necessary referral and/or authorization documentation prior to examination date
• Contacts and follows up with patient’s physician for any missing or incomplete documentation
• Contacts patients to secure past due balances, verifies patient demographics and insurance providers, updates information in systems, and documents conversations
• Answers patient payment, billing, and insurance questions and resolves complaints
• May refer patients to Patient Benefits Representative to set up payment plans
• Contacts third party payors to resolve payor issues, expedite claim processing, and maximize medical claim reimbursement
• Maintains credit balances of patients and payors ensuring timely refunds within government guidelines/regulations
• Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regard to patient records
• Performs other duties as requested or assigned

Benefits

• Health, dental, and vision plans
• Wellness program
• Health savings account - Flexible spending accounts
• 401(k) retirement plan
• Life insurance
• Short-term disability insurance
• Long-term disability insurance
• Employee Assistance Program (EAP)
• Paid Time Off (PTO) and holiday pay
• Tuition discounts with numerous universities

Company Description

We believe these benefits underscore our commitment to the well-being and professional growth of our employees.