Insurance AR Specialist

OneOncology

22h•Remote

About The Position

The Insurance AR Specialist reviews monthly accounts receivable and follows up with insurance carriers and patients to resolve outstanding balances, research issues, and re-file claims when necessary. The role manages insurance accounts for assigned payers and requires expertise in medical billing and collections, insurance reimbursement processes, and regulations related to proton therapy, radiation therapy, and radiology services. The specialist works with patients, physicians, insurance companies, and internal departments to help ensure accurate, timely payments and collection of outstanding balances.

Requirements

High school diploma or equivalent.
At least 3 years of experience in medical collections.
Expertise in insurance policies and regulations related to medical billing, including Medicare and Medicaid.
Detailed knowledge of billing, HCPCS, CPT, and ICD codes.
Ability to work effectively with all levels of management and colleagues, demonstrating initiative, mature judgment, and customer service orientation.
Effective verbal and written communication, including active listening and presenting findings and recommendations.
Strong multitasking and organizational skills and exceptional attention to detail.
Strong analytical skills.
Ability to negotiate issues and resolve problems.
Excellent customer service skills.
Proficiency with productivity applications such as MS Word, Excel, and Outlook, databases, patient billing systems, and other medical information systems.
Ability to operate various types of office equipment.
High degree of professionalism and adaptability.
Attendance is an essential job function.

Nice To Haves

Bachelor’s degree.
Medical collections experience in an oncology healthcare setting.
Radiation oncology or proton therapy experience.
Previous commercial collections experience.

Responsibilities

Work and maintain assigned accounts receivable in the 60+ day categories.
Review EOBs within a two-week turnaround.
Document accurate collection activity in collection tracking notes.
Evaluate account status and prioritize collection actions, including letters, phone calls, and staff assistance.
Contact carriers promptly regarding outstanding balances.
Telephone, interview, and counsel patients regarding outstanding self-pay balances.
Respond promptly to telephone and mail inquiries.
Complete write-off adjustment forms for accounts requiring adjustments and submit them to the supervisor with appropriate documentation.
Maintain collection logs for distribution to other teams to help identify areas needing attention or correction.
Advise the supervisor about unusual collection accounts as they become delinquent or are in question.
Prepare daily user reports for supervisor review and filing, with appropriate notes and documentation.
Work with other departments to gather information needed for account work and collection activity.
Maintain a complete understanding of HCPCS, ICD, and CPT oncology coding and specific carrier requirements.
Perform additional responsibilities as assigned to support the company's mission.