American Oncology Network
Overview
Join to apply for the
Claims Resolution Specialists II
role at
American Oncology Network . Location: Central Georgia Cancer Care Pay Range: $15.83 - $26.38 Responsibilities
Review medical insurance claims for resolution and to obtain appropriate payment through outlined processes. Resolve incoming inquiries, denials and correspondence from various entities to obtain appropriate resolution and payment in a timely manner. Contact insurance carriers to research, compile and respond on open account balances to obtain appropriate payments. Apply billing/collection knowledge required for insurance payers to ensure proper and maximum reimbursement. Respond to patient and office inquiries regarding outstanding insurance balances, insurance payments received, allowable charges, assignment of benefits and any other insurance questions. Manage insurance review and denial of payment by responding with appropriate documentation to support appeal. Follow-up on claims to ensure payment was received. Coordinate effort with office personnel and/or the doctor as necessary. Report any consistent claim denials or problems to the appropriate team lead per payer. Inquire about and resolve any payments that differ from established profile on payer contracts. Attend third party payer meetings, seminars, and training sessions and report any changes or concerns to the supervisor. Follow-up on correspondence in a timely manner. Transfer appropriate balances to patient responsibility per SOP and notify the patient and appropriate department of this action accordingly. Bill applicable secondary insurance. Document all collection activity in Onco EMR, Centricity and Unity. Contact patients to correct insurance information to ensure accuracy as needed. Maintain and ensure the confidentiality of all patient and employee information in accordance with HIPAA and Company policies. Maintain all company equipment in a safe and working order. Work at any Company location to help meet the Company’s business needs. Establish and maintain effective work relationships with new and existing customers through professionalism and excellent interpersonal communication skills. Complete additional reports or projects as assigned by management. Comply with all Federal and State laws and regulations pertaining to patient care, patients’ rights, safety, billing, human resources and collections. Adhere to all Company and departmental policies and procedures, including IT policies and Disaster Recovery Plan. Required Qualifications
High School diploma or GED required. At least 1 year of prior work experience in the medical field, as well as experience in medical billing and/or collections. Excellent knowledge of insurance carrier billing and reimbursement with knowledge of medical terminology, ICD-9, ICD-10 and CPT codes. In-depth understanding of explanation of benefits (EOB). EMR experience; GE Centricity Practice Management software experience preferred. Knowledgeable in Medical Oncology/Hematology and/or Radiation, Pathology, Radiology, Pumps and Specialties. Excellent communication and interpersonal skills; able to work independently as well as in a team. Must complete 6 CEUs annually. Notes
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Join to apply for the
Claims Resolution Specialists II
role at
American Oncology Network . Location: Central Georgia Cancer Care Pay Range: $15.83 - $26.38 Responsibilities
Review medical insurance claims for resolution and to obtain appropriate payment through outlined processes. Resolve incoming inquiries, denials and correspondence from various entities to obtain appropriate resolution and payment in a timely manner. Contact insurance carriers to research, compile and respond on open account balances to obtain appropriate payments. Apply billing/collection knowledge required for insurance payers to ensure proper and maximum reimbursement. Respond to patient and office inquiries regarding outstanding insurance balances, insurance payments received, allowable charges, assignment of benefits and any other insurance questions. Manage insurance review and denial of payment by responding with appropriate documentation to support appeal. Follow-up on claims to ensure payment was received. Coordinate effort with office personnel and/or the doctor as necessary. Report any consistent claim denials or problems to the appropriate team lead per payer. Inquire about and resolve any payments that differ from established profile on payer contracts. Attend third party payer meetings, seminars, and training sessions and report any changes or concerns to the supervisor. Follow-up on correspondence in a timely manner. Transfer appropriate balances to patient responsibility per SOP and notify the patient and appropriate department of this action accordingly. Bill applicable secondary insurance. Document all collection activity in Onco EMR, Centricity and Unity. Contact patients to correct insurance information to ensure accuracy as needed. Maintain and ensure the confidentiality of all patient and employee information in accordance with HIPAA and Company policies. Maintain all company equipment in a safe and working order. Work at any Company location to help meet the Company’s business needs. Establish and maintain effective work relationships with new and existing customers through professionalism and excellent interpersonal communication skills. Complete additional reports or projects as assigned by management. Comply with all Federal and State laws and regulations pertaining to patient care, patients’ rights, safety, billing, human resources and collections. Adhere to all Company and departmental policies and procedures, including IT policies and Disaster Recovery Plan. Required Qualifications
High School diploma or GED required. At least 1 year of prior work experience in the medical field, as well as experience in medical billing and/or collections. Excellent knowledge of insurance carrier billing and reimbursement with knowledge of medical terminology, ICD-9, ICD-10 and CPT codes. In-depth understanding of explanation of benefits (EOB). EMR experience; GE Centricity Practice Management software experience preferred. Knowledgeable in Medical Oncology/Hematology and/or Radiation, Pathology, Radiology, Pumps and Specialties. Excellent communication and interpersonal skills; able to work independently as well as in a team. Must complete 6 CEUs annually. Notes
LI-Onsite
#J-18808-Ljbffr