[Hiring] Medical Insurance Specialist @The US Oncology Network

Role Description

With minimal supervision, is responsible for payer and patient account balances being paid timely and remaining current. Performs collection activities such as:

• Monitoring delinquent accounts
• Contacting patients for account payment
• Resolving billing problems
• Answering routine to complex account inquiries

Performs responsibilities within standard procedures and pre-established guidelines to complete tasks. Supports and adheres to The US Oncology’s Compliance Program, including the Code of Ethics and Business Standards, and The US Oncology’s Shared Values.

Responsibilities

• Monitors delinquent accounts and performs collection duties
• Reviews reports, researches and resolves issues
• Reviews payment postings for accuracy and to ensure account balances are current
• Works with co-workers to resolve insurance payment and billing errors
• Monitors and updates delinquent accounts status
• Recommends accounts for collection or write-off
• 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
• Maintains credit balances of patients and payors ensuring timely refunds within government guidelines/regulations
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient records
• Performs other duties as requested or assigned

Qualifications

• 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 & federal collections guidelines
• Must successfully complete required e-learning courses within 90 days of occupying position

Requirements

• Uses Technical and Functional Experience
• Possesses up to date knowledge of the profession and industry
• Accesses and uses resources when appropriate
• Demonstrates Adaptability
• Handles day to day work challenges confidently
• Is willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change
• Shows resilience in the face of constraints, frustrations, or adversity
• Demonstrates flexibility
• Customer Service: Demonstrates positive interpersonal relations in dealing with fellow employees, supervisors, physicians, patients as well as outside contacts
• Uses Sound Judgment
• Makes timely, cost effective, and sound decisions
• Makes decisions under conditions of uncertainty
• Shows Work Commitment: Sets high standards of performance
• Pursues aggressive goals and works efficiently to achieve them
• Commits to Quality: Emphasizes the need to deliver quality products and/or services
• Defines standards for quality and evaluates products, processes, and services against those standards
• Manages quality and improves efficiencies

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 accommodation will be offered 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
• Occasionally stand, walk, and reach with hands and arms
• 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 accommodation will be offered to enable individuals with disabilities to perform the essential functions. Work is performed in a remote home office environment, involving frequent interaction with other employees, payers, and Practice staff.