Insurance Specialist

The US Oncology Network•Teaneck Township, NJ

7d•Remote

About The Position

Regional Cancer Care Associates (RCCA) is seeking a detail-oriented and motivated Insurance Specialist to support accurate billing, timely payments, and service to patients. This full-time position is listed as remote in Teaneck, New Jersey, with compensation of $18.99–$29.22 per hour. Compensation packages are based on skills, experience, and qualifications. The role supports billing and collections, claim resolution and reimbursement, account reconciliation, patient documentation, and responses to patient and payer questions. It also requires adherence to confidentiality and applicable state and federal laws and guidelines regarding patient records. The position may involve in-person interaction at office sites and minimal travel by automobile. The physical demands include sitting or standing, talking and hearing, a full range of body motion, handling and lifting patients, manual and finger dexterity, eye-hand coordination, and extensive periods of standing and walking. Occasional lifting and carrying of items weighing up to 40 pounds is required. Corrected vision and hearing to the normal range are also required. The work environment may involve exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations, and other conditions common to an oncology/hematology clinic.

Requirements

High school diploma or equivalent.
At least four years of combined medical billing and payment experience.
Knowledge of medical coding, preferably oncology coding.
Knowledge of state, federal, and third-party claims processing.
Knowledge of state and federal collections guidelines.
Successfully complete required e-learning courses within 90 days of occupying the position.

Responsibilities

Monitor delinquent accounts and perform collection duties.
Review reports, identify denied claims, research and resolve issues, reconcile accounts when needed, and resubmit claims to payers.
Review payment postings for accuracy and ensure account balances are current.
Work with co-workers to resolve payment and billing errors.
Monitor and update delinquent account status.
Recommend accounts for collection or write-off.
Verify that existing patients have necessary referral and/or authorization documentation before examination dates.
Contact and follow up with patients’ physicians regarding missing or incomplete documentation.
Contact patients to secure past-due balances, verify patient demographics and insurance providers, update information in systems, and document conversations.
Answer patient questions about payments, billing, and insurance, and resolve complaints.
Refer patients to a Patient Benefits Representative to arrange payment plans when appropriate.
Contact third-party payers to resolve payer issues, expedite claim processing, and maximize medical claim reimbursement.
Maintain patient and payer credit balances and ensure timely refunds within government guidelines and regulations.
Adhere to confidentiality requirements and state, federal, and HIPAA laws and guidelines regarding patient records.
Perform other duties as requested or assigned.