Healthcare Insurance Specialist - Revenue Cycle (A/R & Appeals)
About The Position
Shenandoah Oncology is looking for a Medical Insurance Specialist that will embody our core values, The RETIC Way: Respect, Excellence, Teamwork, Integrity, and Compassion. The Medical Insurance Specialist manages medical billing and insurance accounts by resolving claim discrepancies, working insurance accounts receivable (A/R), preparing and submitting payer appeals for denied claims, and securing outstanding balances. This role ensures accurate payment posting, refunds, and account resolution while serving as a patient‑facing resource for billing and insurance inquiries. All responsibilities are performed in strict compliance with HIPAA and applicable regulatory requirements.
Requirements
- High School diploma or equivalent required
- Minimum two (2) years combined medical revenue cycle (billing, A/R, and denial) experience.
- 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
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.
- 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
Benefits
- We offer a competitive benefits package that includes medical, dental, vision, life insurance, short-term and long-term disability coverage, generous PTO, an employer match 401K plan, a wellness program, tuition reimbursement, an employee assistance program (EAP), and retail discounts.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
