Insurance Specialist - (A/R & Appeals)
About The Position
Shenandoah Oncology is looking for a Healthcare 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.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
501-1,000 employees
