Medical Insurance Specialist

US Oncology Network • Norfolk, VA

411d • $41,600 - $49,920

About The Position

The Medical Insurance Specialist is responsible for managing payer and patient account balances, ensuring timely payments, and performing collection activities. This role involves monitoring delinquent accounts, resolving billing issues, and adhering to compliance standards within the oncology care environment. The position supports the mission of The US Oncology Network, which is dedicated to advancing cancer care in America.

Requirements

• High School diploma or equivalent required.
• Associates degree in Finance, Business or four years revenue cycle experience preferred.
• Minimum two (2) years insurance resolution experience resolving issues with patients and payers as well as four (4) years combined medical billing and payment experience required.
• Proficiency with computer systems and Microsoft Office (Word and Excel) required.
• Demonstrate knowledge of oncology medical 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, and may perform a detailed reconciliation of accounts.
• Reviews payment postings for accuracy and ensures 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 HIPAA laws and guidelines with regard to patient records.
• Proactively identifies processes and procedures and develops tools to improve efficiencies.
• Performs other duties as requested or assigned.

Benefits

• Medical Health Care
• Dental Care
• Vision Plan
• 401-K with a matching component
• Life Insurance
• Short-term and Long-term disability
• Wellness & Perks Programs

What This Job Offers

• Job Type: Full-time
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED