The US Oncology Network
Overview
This is a full-time Monday through Friday 8am-5pm position. Additionally, it is desired that the candidate reside in Texas.
This position can be either a level 1, 2 or Sr based on candidate experience. The US Oncology Network is looking for an
Insurance Specialist
to join our team at
Texas Oncology . This full-time hybrid remote position will support our Regional Business Office at 8501 N. Mopac Suite 310 - Austin, TX 78759. Responsibilities Monitors delinquent accounts and performs collection efforts with payers. Identifies trends with payor and reports to leadership timely. Attends payor calls with regional representatives for collaborative resolution. Prepares comprehensive appeals to resolve denials with insurance companies. Reviews reports, researches and resolves issues. Reviews payment postings for accuracy and to ensure account balances are accurate. 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. 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 HIPAA laws and guidelines with regard to patient records. Performs other duties as requested or assigned.
Qualifications
The ideal candidate for the position will have the following background and experience: Level 1
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.
Level 2
Minimum four (4) years combined medical billing and payment experience required. Demonstrate knowledge of medical coding, preferably oncology coding.
Level Sr
Associates degree in Finance, Business or four years revenue cycle experience preferred. Minimum two (2) years insurance resolution experience resolving issues with patients and payers as well as four (4) years combined medical billing and payment experience required. Proficiency with computer systems and Microsoft Office (Word and Excel) required. Demonstrate knowledge of oncology medical coding. Demonstrate knowledge of state, federal, and third party claims processing required.
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 accommodations may be made 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. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must 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 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. #J-18808-Ljbffr
This is a full-time Monday through Friday 8am-5pm position. Additionally, it is desired that the candidate reside in Texas.
This position can be either a level 1, 2 or Sr based on candidate experience. The US Oncology Network is looking for an
Insurance Specialist
to join our team at
Texas Oncology . This full-time hybrid remote position will support our Regional Business Office at 8501 N. Mopac Suite 310 - Austin, TX 78759. Responsibilities Monitors delinquent accounts and performs collection efforts with payers. Identifies trends with payor and reports to leadership timely. Attends payor calls with regional representatives for collaborative resolution. Prepares comprehensive appeals to resolve denials with insurance companies. Reviews reports, researches and resolves issues. Reviews payment postings for accuracy and to ensure account balances are accurate. 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. 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 HIPAA laws and guidelines with regard to patient records. Performs other duties as requested or assigned.
Qualifications
The ideal candidate for the position will have the following background and experience: Level 1
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.
Level 2
Minimum four (4) years combined medical billing and payment experience required. Demonstrate knowledge of medical coding, preferably oncology coding.
Level Sr
Associates degree in Finance, Business or four years revenue cycle experience preferred. Minimum two (2) years insurance resolution experience resolving issues with patients and payers as well as four (4) years combined medical billing and payment experience required. Proficiency with computer systems and Microsoft Office (Word and Excel) required. Demonstrate knowledge of oncology medical coding. Demonstrate knowledge of state, federal, and third party claims processing required.
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 accommodations may be made 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. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must 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 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. #J-18808-Ljbffr