A/R & Authorization Specialist - Not a Remote Position

Cancer Specialists LLC•Jacksonville, FL

27d•Onsite

About The Position

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.

Requirements

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

Responsibilities

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