Insurance AR Specialist

OneOncology

11d•Remote

About The Position

The Insurance AR Specialist reviews monthly accounts receivable and follows up to resolve outstanding claims, contacts insurers, and re-files claims when necessary. The role manages all aspects of insurance accounts for assigned payers, including follow-up, research, and problem resolution. It requires expertise in medical billing and collections and a strong understanding of insurance reimbursement processes and regulations related to proton therapy, radiation therapy, and radiology services. The specialist works with patients, physicians, and insurance companies 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 skills, including active listening and presenting findings and recommendations.
Strong multitasking and organizational skills and exceptional attention to detail.
Strong analytical skills.
Skill in negotiating issues and resolving problems.
Excellent customer service skills.
Proficiency with end-user productivity applications such as MS Word, Excel, and Outlook, as well as databases, patient billing, 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 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 collection activity accurately in collection tracking notes.
Evaluate account status and prioritize collection actions, including letters, phone calls, and requests for staff assistance.
Contact carriers in a timely manner regarding outstanding balances.
Telephone, interview, and counsel patients regarding outstanding self-pay balances.
Respond promptly to incoming 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 of 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.
Take on additional responsibilities as assigned to support the organization's mission.