Insurance Specialist

The US Oncology Network•Teaneck Township, NJ

7d•Remote

About The Position

Make an impact in patient care—behind the scenes. Regional Cancer Care Associates (RCCA) is seeking a detail-oriented and motivated Insurance Specialist to join our growing team. In this vital role, you will help ensure patients receive the care they need by supporting accurate billing, timely payments, and exceptional service.

Requirements

High School diploma or equivalent required
Minimum four (4) years combined medical billing and payment experience required
Demonstrate knowledge of medical coding, preferably oncology coding
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, identifies denied claims, researches and resolves issues, may perform a detailed reconciliation of accounts, and resubmits claim to payer
Reviews payment postings for accuracy and to ensure account balances are current
Works with co-workers to resolve payment and billing errors
Monitors and updates delinquent accounts status
Recommends accounts for collection or write-off
Verifies existing patients have necessary referral and/or authorization documentation prior to examination date
Contacts and follows up with patient’s physician for any missing or incomplete documentation
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
Contacts third party payors to resolve payor issues, expedite claim processing, and maximize medical claim reimbursement
Maintains credit balances of patients and payors ensuring timely refunds within government guidelines/regulations
Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regard to patient records
Performs other duties as requested or assigned